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NHS-England-logoMarch 11 2015

NHS England has announced the first 29 areas that will redesign care based on ideas put forward by local health and social care professionals.

The ‘vanguard’ geographies have been selected based on the most innovative plans put forward by 269 groups of doctors, nurses and other health and social care staff. Among the proposals which it is suggested will benefit 5 million patients when they ideas start to be implemented from April are:

•    GPs and cancer and dementia specialists working together to reduce the need for hospital visits for patients
•    having a single point of access for GPs, community nurses , social and mental health services
•    making tests, dialysis or chemotherapy more accessible by bringing them closer to home.

“Each vanguard site will take a lead on the development new care models which will act as the blue prints for the NHS moving forward and the inspiration to the rest of the health and care system,” says NHS England. It is backing the proposals with a new £200 million transformation fund and tailored national support.

The different schemes have been grouped under three model types:

•    Integrated Primary and Acute Care Systems (PACs) – joining up GP, hospital, community and mental health services
•    Multispecialty Community Providers (MCPs) – moving specialist care out of hospitals into the community
•    Enhanced health in care homes – offering older people better, joined up health, care and rehabilitation services

Videos describing each of the 29 sites have been posted on YouTube - each runs for 10-15 minutes.

The announcement was made ahead of ‘NHS Change Day’ (March 11). Simon Stevens, the Chief Executive of NHS England, said: “The NHS now has its own long term plan, backed by just about everybody, and today we’re firing the starting gun.

“Instead of the usual top-down administrative tinkering, we’re backing radical care redesign by frontline nurses, doctors and other staff – in partnership with their patients and local communities. From Wakefield to Whitstable, and Yeovil to Harrogate, we’re going to see distinctive solutions to shared challenges, which the whole of the NHS will be able to learn from.”

Dr Chaand Nagpaul, BMA GP committee chair, said that the vanguard proposals represent a “radical change” to the way patient care is delivered in the NHS.

“If implemented properly and led by clinicians, these models have the potential to break down disruptive organisational barriers between GP, hospital and community services. There are too many instances where different parts of the NHS are wasting resources and increasing workload, such as the time consuming re-referrals of patients from one service to another,” he said.

“By encouraging greater collaboration workload pressures could be reduced, while patients will get more effective, joined up care.” However to achieve its aims, the long-term under-resourcing of general practice must be addressed, he added. “It is also vital that these changes maintain the essential strengths of the personalised care provided by GPs to registered lists of patients.”

NHS England says support will be tailored to the needs of each area, and could combine a range of aspects. These include peer learning and expertise in areas such as patient empowerment and community engagement, leadership, clinical workforce redesign, using digital technology to redesign care, devising new legal forms and new contractual models. It will also include joined-up procurement.

“All areas will benefit from a wider support and learning package which will be rolled out later this year, based on the learning from the vanguard sites,” it says.

“Additionally, as a result of the many examples of excellent models up and down the country, a wider programme of support is being put in place for some of the health and social care systems that applied to be part of the programme. This is being supported by the Kings Fund.”

Links:

NHS England announcement

Map of 29 vanguard sites and links to YouTube videos

BMA comment

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