Developing new care models through NHS vanguards

The vanguard programme, one of NHS England’s attempts to better meet patients’ needs and deliver savings by developing new care models to integrate health and social care services, has not delivered the depth and scale of transformed services it aimed for at the beginning of the programme, according to this report by the National Audit Office.

A key objective of the programme was to design new care models that could be quickly replicated across England. NHS England selected 50 sites to act as ‘vanguards’ which might entail, for example, joining up GP, hospital and community and mental health services in an integrated network or single organisation in one area to improve healthcare for patients.

NHS England’s early planning assumption was £2.2 billion of funding for new care models between 2016-17 and 2020-21, but it used much of the funding to reduce deficits faced by hospitals. Actual direct funding of vanguards was £329 million over three years from 2015-16, with another £60 million spent by NHS England on central support for vanguards. Consequently, with less funding for transformation, the original intention to expand the programme was not realised.

Despite not meeting its original intention to expand the models across the country, vanguards have made progress in developing new care models. NHS England forecasts that vanguards will make net savings. As at April 2018, it estimated that vanguards would secure £324 million net savings annually by 2020-21, which is 90% of the £360 million that had been expected.

Full report:  Developing new care models through NHS vanguards

See also: National Audit Office press release

General Practice Forward View

This infographic from NHS England illustrates some of the key areas of progress, two years into the implementation of the General Practice Forward View programme.

Image source: http://www.england.nhs.uk

Digital change in health and social care

This Kings Fund report aims to support  local organisations looking to undertake large-scale digital change. The document states that the future is bright for technology in health and social care, with local care providers digitising under their own steam and initiative.

The report shares the lessons from five varied case study sites that have made significant progress towards their digital aims. It sets out the lessons learnt and tips for other organisations that are looking to progress their own digital change.

Overview

• The use of digital technology in health and social care can improve quality, efficiency and patient experience as well as supporting more integrated care and improving the health of a population.
• Large-scale change involving digital technology, such as adopting electronic patient records (EPRs) and shared care records, is complex and necessitates attention to particular aspects of the change.
• This report shares practical learning from a series of case studies where significant largescale digital change is happening.
• Key barriers to successful digital change include the constraints care organisations face in their workforce, tight budgets, organisations’ attitudes towards risk and the relationships that exist between care providers and key stakeholders.
• Most of the barriers can be mitigated through time and effort and by treating digital projects as change projects, not IT projects. Effective and consistent staff engagement and resource allocation to the project are key factors in success.

The Kings Fund have also produced an interactive map which brings together case studies from across England, highlighting some of the places that are experimenting with and implementing new technologies to achieve better health outcomes or more efficient care.

Full report: Digital change in health and social care

A summary of the report is available here

New chair appointed to improve patient access to innovation in the NHS

Lord Ara Darzi has been appointed as chair of the Accelerated Access Collaborative, a joint government–industry group to speed up patient access to ground-breaking technologies and treatments.

The Accelerated Access Collaborative brings together leaders from the NHS, industry and government to identify the most transformative medical innovations, and will oversee a fast-track route to allow these innovative technologies to be available on the NHS up to 4 years earlier.

Under this Accelerated Access Pathway, launching later this year, a number of the most promising products will be accelerated through the clinical development and NHS approval processes to treat conditions such as cancer, diabetes and dementia.

The project builds on an £86 million funding package to help innovators of all sizes gain access to the NHS market and get their products to patients.

Lord Darzi is a former minister at the Department of Health and Social Care, chair of Imperial College Health Partners, and chairman and director of the Institute of Global Health Innovation.

Full story at Department of Health and Social Care

The learning disability improvement standards for NHS trusts

NHS Improvement | June 2018 | The learning disability improvement standards for NHS trusts

NHS Improvement have developed new standards which have been developed with a number of outcomes created by people and families — which clearly state what they expect from the NHS. By taking this approach to quality improvement, it places patient and carer experience as the primary objective, as well as recognising the importance of how the NHS listens, learns and responds in order to improve care.

Image source: improvement.nhs.uk

There are four standards, which include:

• respecting and protecting rights
• inclusion and engagement
• workforce
• learning disability services standard (aimed solely at specialist mental health trusts providing care to people with learning disabilities, autism or both)

Source: NHS Improvement 
The learning  disability improvement standards for NHS trusts

Easy read version: the learning disability improvement standards for NHS trusts

Digital change in health and social care

The King’s Fund | June 2018 | Digital change in health and social care

A new publication from The King’s Fund has been created to support health and social care organisations that are looking to undertake large-scale digital change, no matter what their current level of technological advancement. The report offers a practical understanding of the factorsthat contribute to successful large-scale digital change by bringing together theexperiences of five case study sites that have already made significant progress towards achieving their change aims.

Although The King’s Fund frame this report in terms of ‘digital change’, it is important to note that for many of the people they spoke to for this research, this was a clinical change process, not specifically a digital one.

• The use of digital technology in health and social care can improve quality, efficiency and patient experience as well as supporting more integrated care and improving the health of a population.
• Large-scale change involving digital technology, such as adopting electronic patient records (EPRs) and shared care records, is complex and necessitates attention to particular aspects of the change.
• This report shares practical learning from a series of case studies where significant largescale digital change is happening.
• Key barriers to successful digital change include the constraints care organisations face in their workforce, tight budgets, organisations’ attitudes towards risk and the relationships that exist between care providers and key stakeholders.
• Most of the barriers can be mitigated through time and effort and by treating digital projects as change projects, not IT projects. Effective and consistent staff engagement and resource allocation to the project are key factors in success (The King’s Fund).

Among the case studies featured in the report are  Essex Partnership University NHS Foundation Trust, Berkshire and Frimley and Homerton University Hospital.

Image source: kingsfund.org

 

You can download both the summary and the full report 
Of interest:

Map of technology and data in health and care

Reducing reliance on medical locums: a practical guide for medical directors

NHS Improvement | June 2018 | Reducing reliance on medical locums: a practical guide for medical directors

The guide gives six practical steps to addressing over-reliance on medical locums and taking great control of workforce deployment. It also contains case studies from trusts who have been successful in finding alternatives to using medical locums (NHS Improvement).

Image source: improvement.nhs.uk

Supporting documents:

Board reporting dashboard template

Use this template to produce monthly reports for your trust board and more regular reports to your executives in charge of reducing medical locum spend

Reporting and tracking template

This spreadsheet provides a guide to some of the information your central booking team should be providing your executives in charge of reducing medical locum spend.

Reducing reliance on medical agency staff: sharing successful strategies

This document reflects some of the strategies being adopted by trusts to reduce reliance on medical agency staff. All the trusts included in this document have a relatively lower medical agency spend in comparison to other trusts in their region as a result of these common strategies and other strategies reflected in this document.

Further details from NHS Improvement 

The five essential components of value-based approaches to health and care

Against a backdrop of financial pressures, growing demand for services and the quest for transformation of local services, the concept of value in the health and care system is one which has gained increasing prominence over recent years. This paper explores how we can spread the adoption of value-based healthcare across all parts of the system and ensure that we maximise the benefits for those who use NHS and wider services | NHS Confederation

This paper explores the central challenge of how to take value-based healthcare to the next stage and embed it across the whole system.

It explores five key characteristics/factors which support the wholesale adoption of value-based healthcare approaches. These are:

• Learning and adapting through the adoption of innovation
• Managing risk
• Making best use of data
• Thinking about pathways across the whole system
• Listening to patients.

Full document: Taking the value-based agenda forward: The five essential components of value-based approaches to health and care