In 2015, NHS England selected 50 sites to act as ‘vanguards’ to lead the development of five new care models. The vanguard programme is another attempt by the NHS to transform and integrate health and social care services, following the integrated care pilots and the integrated care pioneers. The vanguards were intended to be locally driven pilots but each would contribute to the development of care model prototypes that could later be replicated rapidly across England.
Since 2015, NHS England has provided a total of £329 million to the 50 vanguards to support them in testing their proposed new care models. NHS England also spent another £60 million on its new care models programme, which supported and monitored the progress of vanguards. The vanguard phase of the new care models programme ended in March 2018, by which time NHS England expected individual vanguards to be sustainable without further national funding for transformation. Responsibility, along with some members of the new care models team, was passed to NHS England’s new System Transformation Group.
This report from the national Audit Office (NAO) examines whether the NHS is well placed to get value for money from its investment in developing new care models through vanguards. In particular, it focuses on:
- set up and management of the vanguard programme (Part One);
- national support and evaluation (Part Two);
- progress made by the vanguards (Part Three); and
- readiness for the spread of these new care models (Part Four).
The report focuses primarily on the two types of vanguards which were designed to test integrated models of health and social care for a local population: integrated primary and acute care systems (PACs) and multispecialty community providers (MCPs). The report also covers the six enhanced health in care homes (EHCHs) vanguards and the 13 acute care collaborations (ACCs) vanguards. They excluded from the report the eight urgent and emergency care (UECs) vanguards, which were all moved to another part of NHS England after the first year.