• Almost one third of vanguard sites have said they will reduce emergency admissions by 3 per cent
  • Vanguards not expecting reductions in outpatient, elective care and A&E attendances
  • 15 vanguard sites have predicted they will save £107m by 2021
  • Dorset acute care collaboration to save £6m by 2021 through shared pathology service

National vanguards believe they can reduce emergency admissions by almost 3 per cent over the next four years, HSJ analysis of their forecasts shows.

The activity forecasts of 15 vanguard sites show an aggregate reduction of 2.9 per cent between 2016-17 and 2020-21.

Financial forecasts show this group hope to save a total £107m as a result of avoided emergency admissions between 2017-18 and 2020-21.

HSJ analysed the activity figures for: five multispecialty community providers; four primary and acute care systems; four care home vanguards; and two acute care collaborations.

Emergency admissions is the only acute activity which is forecast to reduce. The plans state that accident and emergency attendances will grow by 4 per cent over the period – still a significant slowing from current national trend.

Greater growth is expected in outpatient appointments and elective admissions – 27 per cent and 26 per cent respectively. Several sites made no forecasts for elective care.

NHS England has said its analysis shows PACS and MCP vanguards are already seeing lower growth in the population rate of emergency admissions than the rest of England.

According to our analysis of predicted savings, these vanguards claim they will save £107m in avoided emergency admissions, £36m in avoided A&E attendances, £50m in elective care, and £25m in outpatient appointments.

In total they say they will avoid 43,000 emergency admissions, 109,000 emergency department attendances, 120,000 outpatient appointments and 12,000 elective admissions by 2020-21.

It is not clear whether vanguards’ forecasts assume that they will be expanded. They make varying assumptions about activity growth.

While 20 vanguards provided financial forecasts to HSJ, five ACC vanguards were excluded from the activity analysis because they did not expect an impact on this, instead focusing on other savings.

The 15 vanguards in the activity analysis

  • Merit, focusing on improvements in mental healthcare across the West Midlands
  • The Neuro Network, The Walton Centre Foundation Trust
  • Gateshead Care Home Project
  • Dudley MCP
  • Harrogate integrated acute and primary care collaboration
  • My Life A Full Life (Isle of Wight PACS)
  • Mid-Nottinghamshire Better Together (PACS)
  • Modality Birmingham and Sandwell MCP
  • Better Care Together PACS, Morecambe Bay
  • All Together Better Sunderland (PACS)
  • Sutton Homes of Care
  • Tower Hamlets Integrated Provider Partnership (MCP)
  • Connecting Care – Wakefield District (MCP)
  • West Wakefield Health and Wellbeing (care homes vanguard)
  • East and North Herts Care Home Project

Exclusive: Vanguards target 3 per cent cut in emergency admissions