• NHS Improvement document says after 2017-18, STPs will take the place of the vanguard programme
  • Central new care models team will carry on beyond next year

Vanguard sites will not have transformation funding allocated directly to them from NHS England after next year, it has been confirmed.

The programme, which supports 50 sites to develop five types of new care model, with the backing of centrally allocated “transformation funding”, was launched in early 2015. Its aim is to enable the implementation of the Five Year Forward View by transforming the delivery of care, including via new organisational forms and new types of contract.

The project in its initial form will cease at the end of 2017-18, as any future tranches of transformation funding will be allocated via the sustainability and transformation plan process.

A document on the oversight and governance of new care models published this month by NHS Improvement says: “We expect STPs to play a significant role in helping to align planning requirements and incorporating plans for new care models, particularly once the vanguard programme ends in 2017-18 and transformational funding becomes conditional on STPs.”

HSJ understands transformation funding will be directly allocated to vanguard sites in 2017-18 as it has been this year and last year, with vanguards continuing to be supported by the central new care models team.

Beyond then STPs will be the main instrument for implementing the forward view. HSJ understands the central new care models team will remain but NHS England’s regional teams, which will be responsible for ensuring STPs succeed, will be in charge of extending new care models, including via the allocation of any future tranches of transformation funding.

In its mandate to NHS England, published late last year, the Department of Health set an expectation that 50 per cent of the population of England will be covered by new care models by 2020.

NHS England’s 2016-17 planning guidance also said: “STPs will become the single application and approval process for being accepted onto programmes with transformational funding for 2017-18 onwards.” But it made no explicit mention of the future of the vanguard programme.

It means the direct funding of the existing vanguards will stop before most sites will be able to demonstrate the success of their model. In their applications for transformation funding, vanguards have calculated the likely return on investment by 2020-21.

It is unlikely that many vanguards will be running in their final form before the programme ends. For example, the multispecialty community provider in Dudley – one of the vanguards where plans are most advanced and most public – does not expect to be operating under a new contractual form until 2018.

HSJ also understands few other MCPs or primary and acute care systems are likely to have transferred to a new organisational form and new contracts before the end of 2017-18.

A spokesman for the new care models programme said: ”The vanguards, by their very nature, won’t be vanguards forever, but the new care models programme will continue. The aim has always been to work with the vanguards, as part of a three year period of national investment in the first wave of sites taking forward new care models, to share their learning and best practice and develop frameworks for others to use nationally in order for new models of care to spread across the country.”