• National new care model vanguard projects have not had a major impact on hospital bed days
  • Information revealed in NHS England’s formal vanguard performance dashboard
  • MCPs and PACs have both seen lower growth in the emergency admission rate compared to rest of England
  • Efficiency performance for all national vanguard sites

National new care model vanguard projects have not had a major impact on hospital bed days, official data obtained by HSJ suggests. 

NHS England’s national performance dashboard for the programme shows that, over the measurement period, there was a larger reduction in the rate of hospital bed days in non-vanguard areas than in the nine primary and acute care systems.

Across the 14 multispeciality community providers there was a slightly larger reduction than in the non-vanguard population.

However, the dashboard report shows that vanguards saw substantially lower growth in the rate of emergency admissions over the same period than the rest of England.

Bed days and emergency admissions are the “efficiency” metrics included in the new care models dashboard.

The vanguard dashboard report seen by HSJ compares the rate of emergency admissions and bed days in the 12 months to September 2017, to that in the 2014-15 financial year. It also reveals figures for all the vanguard sites.

In NHS England’s Next Steps on the NHS Five Year Forward View document published last year it cautioned: “Given sample sizes and duration it is important not to over interpret the data currently available.”

Bed days

PACS, MCPs and non-vanguard areas all saw a reduction in the rate of hospital bed days per 1,000 population.

The reduction for PACS was 0.5 per cent, for MCPs it was 1.5 per cent, and for the rest of England it was 1.3 per cent.


Emergency admissions

However, both MCPs and PACS saw substantially slower growth in the rate of emergency admissions per 1,000 population than the rest of England, according to the dashboard. Both groups had a higher rate than the rest of England before the programme started.

Growth for MCPs was 2.6 per cent and for PACS the figure was 1.2 per cent. In areas with no vanguard it was 4.9 per cent.

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The vanguards reporting the largest reductions in emergency admissions over the reported period are: Better Together (Morecambe Bay) PACS, with a 7.8 per cent reduction; Encompass (Whitstable, Faversham & Canterbury) MCP, with a 7.3 per cent reduction; and Connected Care Partnership (Sandwell & West Birmingham) MCP with a 5.8 per cent reduction.

Those which saw the greatest growth were: South Somerset Symphony PACS (15.6 per cent increase) and Dudley MCP (10.8 per cent).

NHS England declined to comment.

In its dashboard NHS England assumes all vanguards started interventions at the beginning of the 2015-16 financial year.

The definition used for bed days is those for specific acute episodes, under the operational information for commissioning definitions. Detailed definitions from the dashboard are attached.


Exclusive: Vanguards dent emergency admissions but not bed days