Sharing learning from new care models

We are continuing our work in collaboration with NHS Confederation, the Local Government Association and NHS Providers to help spread the learning from the NHS England new care models programme and showcase best practice throughout the health and care sector. Throughout 2017 we will be looking at how the ‘vanguards’ are providing the blueprint for the future NHS and working with the STPs and emerging accountable care systems to embed the new models of care as part of the ongoing transformation agenda for health and care systems across England.

The joint project has so far included organising site visits to the new care models, launching resources, recording podcasts and videos with health and care leaders, holding events and publishing case studies, a series of blogs and reports. You can find out more about this work below.

Briefing series

In partnership with NHS Providers, the Local Government Association (LGA) and the NHS Confederation we developed this briefing series to explore four crucial topics for the vanguard areas and offers practical examples from a number of the sites:

  • Improving the experiences of people who use services looks at what the vanguards have been doing IMproving experiences of people who use servicesto improve the way people experience and interact with health and care services, and shares the lessons that other organisations and partnerships can take from the vanguards’ experiences. This includes looking at how we can coordinate care around people’s needs, ensuring people receive high-quality care wherever they are and directing people to care faster.
  • Vanguard-supporting people and communities explores how the vanguards have sought to design1 health and care services around the needs of people who use them, focusing on the outcomes that matter to people and tailoring care to their needs and goals. It also explores how the vanguards have adopted community- and asset-based approaches to consider the broadest possible influencers on health and care.
  • Learning from the vanguards: staff at the heart of new care models looks at how the vanguards 2have broken down traditional organisational barriers across whole systems, how they have engaged staff in the programmes, communicated change and supported staff to work differently. The vanguards have demonstrated the positive impact that effective leadership and open, permissive cultures can have on motivating staff to lead and embrace change.
  • Learning from the vanguards: spreading and scaling up change explores the ten key factors3 that the vanguards have identified are crucial to encourage the spread of initiatives. These include the importance of involving clinicians in change, building shared goals across systems, and creating the time, space and resources for large scale change. This briefing points to how the vanguards have benefitted from the co-ordinated support of the arm’s-length bodies and their permission to ‘fail fast and learn faster’. It also highlights how investing heavily in different ways of sharing learning, building networks and bringing people together, have been critical to the vanguards.

Blogs

Tinson_blogThe most recent blog in the new care models series is from Thomas Marsh, Member Network and Policy Manager at NHS Clinical Commissioners. After a recent visit to Greater Manchester, Thomas reports on how engaged leadership and strong relationships have helped deliver change through devolution.

Read the blog on NHS Voices: How devolution is delivering change in Greater Manchester

Other blogs in the series have included:

Prevention is key for Tower Hamlets Together vanguardPaula Lavis, Member Network and Policy Manager at NHS Clinical Commissioners, shares how the Tower Hamlets Together vanguard is supporting people to stay healthy and to access support earlier to prevent health problems.

Making integrated care happenMichael Macdonnell, national director of health system transformation at NHS England, discusses how NHS trusts are learning from the successes of the vanguards to make integrated care happen.

Strong partnerships central to Connecting Care vanguard’s successesSimon Keen, press officer at NHS Providers, writes about how Wakefield’s Connecting Care vanguard has improved and integrated services for patients and communities.

A unique offering for patients with highly complex needs:  Peter Tinson, chief operating officer at NHS Fylde and Wyre CCG and the senior responsible officer for the Fylde Coast Vanguard, talks about how the Fylde Coast local health economy has developed an innovative new care model for over-60s with multiple conditions and highly complex health needs.

Why care can be nothing less than personalKerry McQuade, head of delivery at All Together Better Sunderland shares how a personal loss propelled a vision of care for the people of Sunderland – and how staff across health and social care are making it a reality.

Ealing’s integrated care journey: learning from international modelsDr Serena Foo, GP partner and member of Ealing CCG governing body, discusses Ealing’s integrated care model and reflects on what they have learnt from the Alzira model in Spain.

Collaboration not competition will allow us to offer the best care: Jeff Johnston, programme director of Cheshire and Merseyside Women’s and Children’s Services Partnership, one of the 13 vanguards developing future models of acute care collaboration talks about its progress.

New models of care in practice – case studies

Since 2015 right across the country the ‘vanguards’ have been working hard to redesign local health and care systems with the aim of improving the care received by millions of people across England – below are some recent examples of where this is working in practice for the benefit of patients and local populations.

Better care Together (Morecambe Bay) (integrated primary and acute care systems vanguard)

Better Care Together (Morecambe Bay) has put listening to its local community and supporting their wellbeing at the heart of its vanguard work. Self-care and prevention are vital to helping people to avoid hospital admissions and live longer, happier lives.

Cambridgeshire and Peterborough CCG (urgent and emergency care vanguard)

This urgent and emergency care vanguard in Cambridgeshire and Peterborough has focused on helping people who are experiencing mental health crisis and demonstrating how, with the right support, they can get the help they need at home or in the community and avoid a trip to A&E.

Connecting Care – Wakefield District (enhanced health in care homes vanguard)

Connecting Care – Wakefield District vanguard has been focusing on improving the health and wellbeing of local care home residents.

East Midlands Radiology Consortium (acute care collaboration vanguard)

The East Midlands Radiology Consortium (EMRAD) network and its new way of working can save money as well as improve the clinical care offered within urgent services such as major trauma and stroke and in regional acute surgical centres.

Mid Nottinghamshire Better Together (integrated primary and acute care systems vanguard)

Mid Nottinghamshire Better Together vanguard is working towards the local health and care system being more joined up, and together partners have been reducing unnecessary hospital admissions for the area’s highest risk patients.

North East Hampshire and Farnham vanguard (integrated primary and acute care systems vanguard)

North East Hampshire and Farnham vanguard is focussing on bringing local primary, community, acute, mental health and social care services together to work as one team to keep the local population healthier.

Royal Free London (acute care collaboration vanguard)

Royal Free London is one of four foundation trusts developing a ‘group model’ – a new way of working across organisational boundaries to improve the quality of patient care, while also reducing the cost to the healthcare economy as a whole.

Tower Hamlets Together (multispecialty community provider vanguard)

Among many other initiatives, the Tower Hamlets Together vanguard has established a new community kidney service which uses technology to help identify and treat patients either at risk of kidney disease or already living with the condition.

Wellbeing Erewash (multispecialty community provider vanguard)

Wellbeing Erewash brings together local health and social care organisations to work as one team. It has shaped a new group of services which are closer to home with patients being supported by a group of professionals working together to prevent ill health, rather than being seen by lots of different professionals individually.

Podcasts

We interviewed a range of NHS leaders about the opportunities and challenges involved in establishing new models of care.

Sarah Morgan, the director of organisational development and vanguard programme director at Guy’s and St Thomas’ NHS Foundation Trust, discusses the partnership between Dartford and Gravesham NHS Trust and Guy’s and St Thomas’ NHS Foundation Trust, an acute care collaboration vanguard, and how it has engaged staff in developing new models of care. Sarah explains how the two trusts are collaborating to create sustainable services and to improve care for people and their families, and highlights how the partnership is supporting clinicians to drive improvements in services and quality. Listen to the podcast.

Lesley Carver, senior project manager and Zoe Richardson, project officer Lesley and Zoefrom Connecting Care Wakefield discuss how the Enhanced Health in Care Homes vanguard is improving the experience of patients accessing services in the area. They discuss some of the initiatives that are improving the way patients access care including the ‘Red Bag’ scheme, which improves access to patient records and ensures patients only have to ‘tell their story once’ throughout their care journey. They share the findings of a year-long evaluation and share their advice for colleagues planning similar schemes. Listen to the podcast.

William Roberts, former new care models programme national lead for enhanced health in care homes at NHS England, offers his insight and experience of successfully spreading change across networks and supporting the spread of innovation across health and care services. He considers the key factors needed to scale up and spread initiatives so that success can be replicated in other places. Listen to the podcast.

Hannah Leaton, vanguard programme lead for Wellbeing at NHS Erewash Clinical Commissioning Group, discusses her experiences at the helm of Wellbeing Erewash vanguard. She explores Wellbeing Erewash vanguard’s ‘time swap’ programme and how it helps people and communities to stay well. Listen to the podcast.

Merran McRae, chief executive of Wakefield Council, talks about her experience of the vanguard programmes in Calderdale and Wakefield, and about what she’s learned. She explains how new models of care are making a positive difference to the experience of patients, reducing the number of professionals involved in care, speeding up access to treatment pathways and empowering the individual. However, these are not perfect systems and Merran shares ideas for areas that could be improved, and her desire for a ‘community of learning’. Listen to the podcast.

Paul Maubach, chief officer of Dudley CCG and lead for the Dudley multispecialty community provider (MCP) vanguard. explores the development of the MCP model in Dudley, the challenges and tensions involved in creating an accountable care organisation and the benefits of working in a ‘team without walls’. Sharing key learning from the journey so far, Paul discusses the importance of staff and public engagement, keeping a focus on outcomes and learning from others along the way. Listen to the podcast.

Sam-EveringtonSir Sam Everington OBE, a GP, chair of Tower Hamlets CCG, clinical adviser to the new care models programme and leader of a vanguard in Tower Hamlets spoke to us. The conversation covers Sam’s views on why relationships are so integral to helping spread innovation and good practice, and the importance of the NHS showing humility when considering the things that contribute towards a person’s health and wellbeing. Listen to the podcast.

John Short, chief executive, Solihull Mental Health NHS Foundation Trust and Andrew Foster, chief executive of Heart of England NHS Foundation Trust provided insight into the motivations for an integrated approach to urgent and emergency care, the changes they want to deliver for their communities as part of this work, and discuss the key roles that each part of the system plays in making this happen. Listen to the podcast.

Heather Tierney-Moore, chief executive of Lancashire Care NHS Foundation Trust, and Jackie Daniel, chief executive of University Hospitals Morecambe Bay Trust, were interviewed about the Better Care Together Vanguard, which both of their trusts are involved in. This is one of nine integrated primary and acute care systems being piloted in England.

Vanguards videos

New care models: What we can learn and the journey to integrated care: We hear from health and care leaders who attended the New care models: What we can learn and the journey to integrated care event in Birmingham.

Attendees tell us what they hoped to learn from senior vanguard leaders and the lessons that they hoped to take back to their own areas.

Vanguard leaders including Dr Andy Haynes, medical director at Mid Nottinghamshire Better Together, Katie Roebuck, MCP programme manager at Connecting Care Wakefield, and Dr Tim Taylor, consultant radiologist and medical director at EMRAD Consortium also share their advice for those preparing to deliver a large scale change programme.

This includes areas such as involving patients in decisions about service transformation, overcoming the difficulties of delivering change in the current constrained climate, and working in partnership with a range of organisations and services.

This video has been produced alongside a briefing series by NHS Providers, NHS Confederation, NHS Clinical Commissioners and the Local Government Association to help share learning from the vanguards.

In August 2017, we launched a video in which those involved in the New Models of Care programme gave their insights into the value of the programmes and what they have learned from being part of a vanguard project.

Resources

In March 2016 we launched an animation and series of factsheets aiming to help health and care staff, patients and the public gain a better understanding of the motivations of the vanguard programme, while explaining some of the innovative work currently making a real difference to people’s lives.

There are currently 50 vanguards across the country grouped under the following care models:

  • NewCare ModelsAcute care collaboration vanguard sites – linking local hospitals together to improve their clinical and financial viability
  • Urgent and emergency care – new approaches to improve the coordination of services and reduce pressure on A&E departments
  • Enhanced health in care homes – offering older people better, joined up health, care and rehabilitation services
  • Multispecialty community providers – moving specialist care out of hospitals into the community
  • Integrated primary and acute care systems – joining up GP, hospital, community and mental health services

Watch the animations on the NHS Confederation website and download the factsheets to find out more; share on social media to help your staff to help create a greater understanding of the programme.

Reports

The NHS Five Year Forward View set out the potential for technology to revolutionise the way health and care is delivered. Our publication New care models: harnessing technology  explores how five of the vanguards are implementing digital technology solutions at the heart of a new approach to care.

Read the report.

Site visits

Health and care leaders will have the opportunity to see first-hand how vanguards are delivering new models of care and implementing innovative transformation programmes as part of an exciting series of vanguard site visits .

Led by those involved in developing the vanguards, the visits will involve a tour of local services, allowing delegates to see change in action for themselves. They will also include an overview of the local health and care economy and opportunities to meet local senior leaders to share experiences of leading transformation programmes.

The next one-day visit is to: Greater Manchester Health and Social Care Partnership

On 26 February we are inviting members to learn about the unique transformation taking place in Greater Manchester as a result of devolution. This visit provides the opportunity to understand more about Greater Manchester’s whole systems-approach by showcasing how integrated and place-based partnership working is happening in practice.

Gain practical insight into how local partners – particularly the NHS and local authorities – have overcome the barriers that have historically precluded partnership working.

The sessions will run from 10.30am to 4.00pm. For more information please visit the NHS Confederation website.

To book your place, email Ben.Augustine@nhsconfed.org

Previous visits have been to:

Updated 10 April 2018