First wedge of £200m transformation funding allocated to vanguards

Over £60m of funding for vanguards has either been allocated or agreed in principle – it will all come from the £200m “transformation fund” given to the NHS to implement the NHS Five Year Forward View last year.

The first vanguard sites to receive transformation funding will be:

• Sunderland, £6.5m;
• Northumberland, £8.3m; and
• south Somerset, £4.9m.

A further £41m has been approved in principle for:

• Morecambe Bay;
• southern Hampshire;
• Isle of Wight;
• Salford; and
• Wirral.

More of the remaining funding will be allocated later in the year. Some will go to vanguard sites trialling new models of urgent and emergency care, announced last week, and the acute sector collaboration vanguards, which are yet to be identified.

Vanguard sites will receive “the bulk” of the £200m fund, although some of it will also support a diabetes prevention programme and moving patients with learning disabilities from NHS to social care.

The £200m is dwarfed by the £1.5bn per year that the Health Foundation and King’s Fund said was the minimum amount needed annually to transform care.

NHS England’s director for new care models, Samantha Jones, told HSJ that funding had been allocated to areas which were able to produce a “value proposition” showing that the investment would save money while improving care.

She added that the vanguards that received funding also had to match it with their own resource “to put their own skin in the game”.

Vanguards receiving transformation funding will be expected to deliver efficiency savings beyond those required by the NHS as a whole by the end of 2017-18.

NHS England has supported vanguard areas to bid for cash. Some existing vanguards were not ready to bid for money initially, but are expected to make submissions in September.

Alongside the first wave of transformation funding, the arm’s length bodies supporting the forward view have today published the programme of support that will be available to vanguard areas.

Support is divided into eight areas:

• designing new care models;
• evaluation and metrics to assess the effectiveness of new care models;
• integrated commissioning and provision – helping vanguards break down barriers between the purchaser and provider of healthcare;
• empowering patients and communities – it will be a requirement for vanguards to demonstrate patient involvement;
• harnessing technology;
• workforce redesign;
• local leadership and delivery, including learning from international exemplars; and
• communications and engagement.

Each domain will be led by a sector expert, alongside a local vanguard leader.

Under this programme of support, by December the new care models team will produce the first draft of a standard contract for multispecialty community providers, and another for primary and acute care systems, for use in vanguard areas.

There will also be guidance on organisational form by the end of this year.

A document detailing the support package, published today, says that the current system of quality payments such as commissioning for quality and innovation, the quality and outcomes framework and the quality premium, “will need to be reimagined and simplified, in order to create aligned, whole system incentives that support new care models”.

The new care models team will publish a suite of “core metrics” for each of the first three vanguard models by October. These will include measures such as rates of emergency admission, bed days, and quality of life for people with long term conditions. This will be accompanied by a standard dashboard to measure progress.

There will also be the opportunity for vanguards to access and share legal advice.