• Nearly all vanguards analysed say they will have saved more than that has been spent on them by the end of 2018-19
  • Require hundreds of millions in local funding from 2018-19, when national funding stops
  • Costs outweighed savings in 2016-17

Next year is expected to be a tipping point, when new care model vanguards will be saving money than is being spent on them, analysis of their forecasts suggests.

HSJ has analysed the financial forecasts submitted to NHS England for 20 of the 50 vanguards.

In aggregate, for 2016-17, the figures show these sites had spent £41m more than they saved.

For 2018-19 onwards, all of the sites predict that they will be saving more in each year than is spent on them.

The data, released under the Freedom of Information Act, also reveals that the 20 vanguard sites expect to require more than £277m in local funding over 2018-2021, after national funds end in 2017-18.

The details are from returns requested by NHS England in February about expected return on investment from 2016-17 to 2020-21.

HSJ analysed templates for 20 vanguards comprising five multispeciality community providers, four primary and acute care systems, four care home vanguards and seven acute care collaborations.

In 2016-17, the 20 sites’ combined costs of £85m outweighed savings of £44m. However, for 2017-18 they are set to make combined net savings of £136m compared to overall national and local investment of £107m.

In 2016-17, 15 sites reported spending more than savings, while just nine predict a loss for 2017-18, and by 2018-19 onwards every site claimed they will be saving more than they invest.

HSJ, in addition to in year figures, calculated the total forecast savings and investment between 2016-17 and 2020-21. National investment in 2015-16 was excluded from vanguards’ calculations because NHS England said this was to establish proposals. These are the figures:

ROI forecasts of the 20 vanguards

VanguardTypeReturn on investment 2016-2021 (excluding capital costs)
 Moorfields Network

Acute care collaboration


Merit vanguard

Acute care collaboration


Developing One NHS in Dorset

Acute care collaboration


National Alliance

Acute care collaboration


The Network

Acute care collaboration


East Midlands Radiology Consortium

Acute care collaboration


Accountable Clinical Network for Cancer

Acute care collaboration


Sutton Homes of Care

Care home


West Wakefield Health and

Care home


Gateshead Care Home Project

Care home


East and North Care Home Project

Care home


All Together Sunderland



Dudley MCP



Modality MCP



Connecting Care – Wakefield District



Tower Hamlets Integrated Provider Partnership



Harrogate integrated care partnership



My Life A Full Life (Isle of Wight)



Better Together (Morecambe Bay)



Mid Nottinghamshire PACs



The biggest return was predicted by the National Orthopaedic Alliance, which plans to improve standards in orthopaedic care by creating a national framework. The project is closely linked with work being done by the Getting It Right First Time programme.

A spokeswoman from the Harrogate vanguard – the only vanguard of the 20 to submit a negative – told that NHS England’s financial template “simply didn’t work for us, but we were required to use it”.

An NHS England spokesperson said: “It’s pleasing to see the vanguard programme coming to fruition with meaningful savings reported in 2016-17. Total predicted savings over the period to 2020-21 are in line with the plans set out in their original funding applications.

“Vanguards have seen lower growth in emergency hospital admissions and emergency inpatient bed days per capita than the rest of England. Care home vanguards are also reporting lower growth in emergency admissions than the rest of the country, as well as generating meaningful savings from reducing unnecessary prescribing costs.

“The vanguards’ care redesigns are, in many parts of the country, now scaling into their wider sustainability and transformation partnerships and accountable care systems, as set out in the Next Steps plan for the next two years.”

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