Vanguards: More transformation funding 'critical' to success

Failure to find more transformation funding could hinder the implementation of the forward view, vanguards have warned.

So far the Treasury has only allocated £200m to fund the transformation of the NHS as described in the forward view, although ministers have faced calls to ringfence significant funds over several years to enable the NHS to establish new models of care.

Vanguards have been required to produce business cases, known as “value propositions”, to demonstrate how the transformation funding allocated to them will be recouped through reduced costs in coming years.

HSJ has learned that these documents typically include estimates of how much more funding will be needed beyond 2015-16.

For instance, one vanguard that is yet to have funding confirmed has requested £5m for 2015-16 and £17m for the following two years.

Katrina Percy, chief executive of Southern Health Foundation Trust, which is part of the southern Hampshire multispecialty community provider vanguard, said further transformation funding was “critical” to the success of the new care models project. She said her vanguard was already showing encouraging signs, such as reduced referral rates from some participating GP practices.

“If we want to see that at scale, we will need investment for longer [than just 2015-16]. We’re counting on it,” she added.

Ms Percy said southern Hampshire, which has received almost £7m this year, could need double that in 2016-17 if a large number of local GP practices decided to join the emerging integrated provider.

Salford’s primary and acute care system vanguard has so far been allocated £5.2m for 2015-16, but it has requested a further £20m to be spread across the following two years.

Jack Sharp, director of service strategy and development at Salford Royal FT, told HSJ: “My understanding is that NHS England is making the case in the next comprehensive spending review for funding to support the vanguard programme.

“The expectation is that additional transformation money will be available in 2016-17 and 2017-18. If this is not forthcoming, we will have to adjust the implementation of our new care model.”

NHS England will not comment on the negotiations around November’s comprehensive spending review. However, it is understood to be approving business cases from vanguards requesting more money beyond 2015-16. This element of the plans has been signed off, subject to further review by NHS England, and the outcome of the CSR, HSJ understands.

During the summer ministers faced calls to find at least £1.5bn of transformation funding per year for the next five years to support new models of care.

Nearly £60m of the £200m 2015-16 transformation fund has been allocated to vanguards pioneering MCPs, PACS and enhanced health in care homes (see box, below).

Further allocations to these types of vanguards are expected. Urgent and emergency care vanguards and acute care collaborations are also expected to receive a slice of the £200m.