'Success regime' outlined by national officials

The regime will also be used in an attempt to move services in areas with serious problems more quickly to the new care models proposed in the NHS Five Year Forward View.

NHS England chief executive Simon Stevens revealed plans for the approach at the HSJ annual lecture, held in conjunction with FTI Consulting, last month. Some further details of the regime were outlined in NHS planning guidance for 2015-16, published shortly before Christmas by NHS England, Monitor and the NHS Trust Development Authority.

The intervention process will be overseen jointly by those organisations under a “single, aligned accountability mechanism”, the guidance said.  

The Local Government Association and the Care Quality Commission are also expected to have some involvement.

A “clear medium term plan for transformation” will be developed during this period, as well as the “single, collective short term plan for the health economy setting out what needs to be achieved during the period of intervention”. Any transitional financial support will be conditional.

Health economies within the regime will also get support from high performing health economies and organisations. The planning guidance said the national oversight bodies would “develop the new regime in a small number of the most challenged areas during 2015-16”, and will set out more detailed guidance on it in “early 2015”.

The success regime is one of “three distinct elements” to national organisations’ approach to implementing the new care models, the planning guidance says.

There will also be “first, focused support for vanguard sites” and a “more permissive approach to change right across the country”.

The vanguard sites, which have to submit interest by the end of the month, will work with national bodies to develop a support package for implementing new models of care and “prototypes” for the models themselves. The models include multispecialty community provider, primary and acute care systems, enhanced health services in care homes and “additional approaches to creating viable smaller hospitals”, such as specialist franchises and management chains.

The planning guidance says: “A support programme will be co-developed rapidly with the initial [vanguard] sites… Practical support could be developed across a number of areas such as designing patient centred care and increasing community involvement; clinical workforce redesign; using digital technology to rethink care delivery; the optimal use of infrastructure; devising organisational legal forms; new contractual models; procurement routes; and capitated payment arrangements.”