The new care model vanguards are delivering the NHS Five Year Forward View vision, including in the reduction of pressure on our NHS

We are all well aware of the pressure our NHS is under with an increase in demand for services, especially from older people with complex conditions.

The new care model vanguards are trying new approaches to reduce this pressure, whether on hospital services, such as A&E or in outpatient clinics, or on GP surgeries and GPs.

A variety of approaches are being taken across the 50 vanguards and we are seeing very promising results.

In London, the team at Tower Hamlets Together vanguard (@TH2GETHER) established an e-referral service for patients with renal problems. The system has drastically cut the number of people having to attend a hospital outpatient appointment, which can be inconvenient, for instance when it is necessary to take time off work.

Fifty per cent of referrals are now being dealt with without the need to visit hospital, with advice being given in an average of five days – compared to 64 days for patients attending hospital.


In Southern Hampshire, Better Local Care vanguard (@BetterLocalCare) has created a ‘Same Day Access Service’ for patients who use four of its GP practices. In just six weeks, 5,500 people were referred to the service, with 3,350 (60 per cent) having their needs met over the telephone rather than having to visit GP surgeries that are part of the vanguard. This has freed up valuable GP time, allowing them to offer longer appointments to patients who have more complex conditions.

It has also reduced the time patients have to wait for routine appointments – down from an average of three to four weeks to between 10 to 14 days.

Since being launched, the service has cut hospital referrals by 70 per cent for patients needing haematology or endocrinology services

Moving north, Stockport Together vanguard (@Stockport2gther) has launched a Consultant Connect service which allows GPs to easily get expert advice from hospital consultants about a patient who has visited their surgery or during a home visit. The service is available seven days a week, 24 hours a day.

The service means GPs can get advice immediately and prevents the need for patients having to be referred to hospital for an outpatient appointment. A “win win” for the patient, GP and hospital.

Since being launched, the service has cut hospital referrals by 70 per cent for patients needing haematology or endocrinology services.

All three of these vanguards are multispecialty community providers, which, along with the other 47 vanguards, are helping to deliver the three aims of the Five Year Forward View: improving the quality of care; preventing ill-health and saving money.

For more information about the new care models programme, click here.

Samantha Jones is director, New Care Models programme. @SamanthaJNHS