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Pilot sites announced in drive to 'transform' NHS models of care

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Community nurses and practice staff will work more closely together with other parts of the healthcare system in a series of new schemes to test more integrated ways of working in the NHS.

The first wave of pilot sites for a series of new NHS models of care, designed to more integrated and multidisciplinary, were announced yesterday by NHS England.  

The so-called “vanguard” pilots are intended to test out in practice the overarching ideas set out in October in the NHS five-year plan – the NHS Five Year Forward View. It was heralded as an major opportunity for nurses and midwives to lead the development of new care approaches.

NHS England said yesterday that 29 vanguards – the most innovative – had been chosen from 269 submissions made by groups of clinicians on how they wanted to redesign care in their areas.

They will be pump-primed with some of a new £200m “transformation fund”, previously announced by NHS England chief executive Simon Stevens.

From April, the vanguards will develop local health and care services to “keep people well, and bring home care, mental health and community nursing, GP services and hospitals together”, said NHS England.

“All of the vanguards have a very strong nursing and multidisciplinary focus among them”

Samantha Jones

As set out in the five-year plan, the vanguards will test out different approaches for three new care models.

These include multi-specialty community providers (MCPs), which are intended to achieve the ongoing NHS goal of moving specialist care out of hospitals into the community.

For example, one site will develop a prevention team made up of health and care professionals including GPs, advanced nurse practitioners, mental health nurses, extended care support and therapy support. 

Led by Derbyshire Community Health Services NHS Foundation Trust, it will support vulnerable people who can be treated for their conditions in the community, but who otherwise might end up in hospital. 

It will include care planning for people with long term conditions including diabetes, chronic vascular disease and chronic lung conditions.

As well as MCPs, some areas will test out models of enhanced health in care homes and also integrated primary and acute care systems (PACS), which join up GP, hospital, community and mental health services.

One site, led by East and North Hertfordshire Clinical Commissioning Group, will focus on enhancing the skills and confidence of care home staff through a package of education and training. 

“Frontline staff are often the driving force behind successful innovation”

Peter Carter

The programme will create dedicated multi-disciplinary teams for care homes, which will include GPs, community psychiatric nurses, district nurses and geriatricians. They will form a rapid response service so care homes have access to a combination of community nurses, matrons, therapists and home carers who can be deployed within 90 minutes if required.

Samantha Jones, director of the new care models programme at NHS England and a former nurse, said that, overall, she had been “really impressed” by the innovations submitted to become vanguards.

“All of the vanguards have a very strong nursing and multidisciplinary focus among them,” she told Nursing Times, noting that many of the presentations given in support of the submissions had been made by nurses.

She added that many of the ideas featured “very strong nursing leadership” and had been “led and shaped by nurses”.

Ms Jones said that NHS England was also considering how it might support the projects that did not win through to become vanguards, so that their work could continue.

NHS England chief executive Simon Stevens added: “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.

Samantha Jones

Samantha Jones

“We’re going to see distinctive solutions to shared challenges, which the whole of the NHS will be able to learn from,” he said.

Peter Carter, chief executive and general secretary of the Royal Colleg of Nursing, said it was “good news” that the aims for innovation set out in the five-year plan was making “steady progress”.

“RCN members across the country look forward to seeing more detail about the individual sites, and how they might learn from their progress,” he said.

“Frontline staff are often the driving force behind successful innovation and change in the health and social care system, and it is vital that they are involved in the programme as it develops, along with patients and carers,” he added.


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