Fears over 'loss of momentum' for new care models as funding shifts

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National funding for vanguard programme ends in March
Ten CCGs confirm they intend to keep funding programmes but most could not confirm amounts
Three CCGs said some vanguard work will continue as part of “business as usual”
Three vanguards will not get any further funding from CCGs

There is a risk of a “loss of momentum” in new care models ahead of a major shift in their funding in the next financial year, the GP lead for two national vanguards has warned.

HSJ asked clinical commissioning groups involved in NHS England’s 14 multispecialty community providers and nine primary and acute care systems whether they intend to fund these vanguards beyond March when national funding is due to end.

Ten CCGs covering eight vanguards said they would keep funding their MCP or PACS in 2018-19. These were:

All Together Sunderland MCP (Sunderland CCG);
Dudley MCP (Dudley CCG);
Fylde Coast Local Health Economy (Blackpool CCG and Fylde and Wyre CCG);
Mid Nottinghamshire Better Together PACS (Mansfield and Ashfield CCG and Newark and Sherwood CCG);
Stockport Together MCP (Stockport CCG);
Tower Hamlets Together MCP (Tower Hamlets CCG);
Wakefield MCP (Wakefield CCG); and
Wirral PACS (Wirral CCG).

Dudley CCG said it planned to allocate £5m for its MCP in the coming years.

Stockport and Wirral CCGs have allocated £800,000 and £500,000 respectively to their vanguards for the next financial year.

No other CCGs could confirm the amount they intend to spend.

Calderdale, Morecambe Bay and North East Hampshire and Farnham CCGs said some vanguard work would continue as “core CCG funding” or as part of “business as usual”, but none of them could confirm how much this would cost.

Nigel Watson, GP lead for the two vanguards in Hampshire, said that despite the fact that some services would continue under core funding, it “is less clear at the moment how we resource locality managers and GPs who are involved in driving that agenda. What we don’t want to do is get rid of all the provider driven stuff and slip back to commissioning as its always been.”

He added: “I think we will lose some of the momentum, some areas will focus on what has been achieved and some will forget about it.

“In the vanguards, commissioners and providers came together with a single voice and it broke down some of the traditional [barriers]. There was much more cohesive relationship. I think there is a risk we will end up with commissioners micromanaging again and lose the efficiency and potential we gained.”

Northumberland, Corby and Harrogate and Rural District CCGs have not committed any funding to their vanguards beyond March.

A spokeswoman for Northumberland CCG said: “The key principle of [the] vanguard was that the work should be self sustaining and we have no planned funding in place past the 31 March 2018.”

A Harrogate and Rural CCG spokesman said: “Our vanguard did not operate as a primary and acute care system. It focused on smaller scale service redesign. Moving forward, the CCG intends to commission a primary care centred, community focused integrated model of care developed from the learning of the vanguard, whilst making the most of national learning.

“The CCG and programme partners have match funded the national funding throughout the lifespan of the programme. Partners have utilised the existing system funding, without any additional financial investment.”

Several CCGs said they had yet to decide whether they will provide further funding for their vanguards, or did not respond. These were: