It’s an exciting time for the NHS, with NHS England capitalising on the passion and energy of local areas who are keen to spearhead improvements by delivering innovative new models of care for their patients which can be rolled out across the NHS.
Since the launch of the first wave of vanguards, a support package has been released by the NHS Five Year Forward View partners (as well as access to the £200m Transformation Fund) to enable them to build on best practice and make effective and speedy changes.
The support package provides amongst other things support on designing new care models, evaluation and metrics, integrated commissioning and provision, and workforce redesign.
NHS England Chief Executive, Simon Stevens, said:
"Led by doctors, nurses and other staff, as well as patients and community groups, the vanguards are being asked to radically redesign the way they provide care. The support package has been designed with and for the vanguards. It provides them with additional tools to move at pace and, importantly, to remove barriers that stop them from delivering the best possible care to patients.”
‘Better Local Care’ (Southern Hampshire) is a great example of one up and running vanguard, which is a multi-specialty community provider (MCP).
Better Local Care is a partnership between GPs, Southern Health NHS Foundation Trust, three clinical commissioning groups (Fareham and Gosport, West Hampshire and South Eastern Hampshire), the voluntary sector and others.
Here clinicians are working together with patient and voluntary groups to develop a model towards collaboration and integration, which breaks down organisational barriers and directly benefits patients.
In his blog for the NHS about the vanguard, Dr Donal Collins has written about a number of care innovations that are being developed within this vanguard, which include:
Same-day appointment service
This idea is being trialled in Gosport, whereby patients are triaged in order to see the right professional and get appropriate advice first time round.
Dr Collins explains that if you rang up to see your GP with back pain, this system ensures that you will get straight to a physiotherapist, and cuts out the delay of seeing a GP first and the usual referral process.
The triaging process will also separate urgent care from care for long-term conditions, meaning that the urgent care service can relieve pressure from the surgery so that they can focus on monitoring patients with long-term conditions.
Patients benefit from this strategy by getting improved access to the right service, with shorter waiting times and longer appointments. And the hope is that eventually this service will be expanded to cover more types of professionals (both allied health professionals and specialisms) and covering the full population in Gosport, allowing GP cover to be scaled up.
The voluntary sector
In a move to tackle the problem of frequent GP surgery attenders, Gosport is also introducing volunteers called ‘surgery sign posters’. These volunteers help give support to people who may for example be suffering from a non-medical problem like loneliness, and could receive the appropriate support they need from a service elsewhere.
Reducing unnecessary medication
In a bid to cut the cost of inappropriate medication, a team of pharmacists, nurse practitioners and GPs with specialist interests will visit every nursing home in Gosport. They will stop inappropriate medication that may have been prescribed some years ago and in future hope to review all patients on a regular basis.
The Better Local Care Vanguard in Southern Hampshire is a great example of primary care innovation in the NHS which will help deliver real results for patients and staff alike. Most recently NHS England announced eight new vanguards that will launch the transformation of urgent and emergency care for more than nine million people. This step towards radical redesign is both streamlining processes while simultaneously improving patient care for huge numbers of people, as well as creating much needed efficiencies for CCG spending. This is an exciting time as the frontiers of the NHS are pushed and transformation takes place.