National Audit Office 29 June 2018
- This report examines whether the NHS is well placed to get value for money from its investment in developing new care models through vanguards. In particular, it focuses on:
- set up and management of the vanguard programme (Part One);
- national support and evaluation (Part Two);
- progress made by the vanguards (Part Three); and
- readiness for the spread of these new care models (Part Four).
- The report focuses primarily on the two types of vanguards which were designed to test integrated models of health and social care for a local population: integrated primary and acute care systems (PACs) and multispecialty community providers (MCPs)
The vanguard programme is one in a series of attempts to transform the NHS to better meet patients’ needs and to respond to the financial pressures it faces. However, short-term financial pressures led to the diversion of much of the transformation funding, weakening the programme’s chances of success. Individual vanguards have made progress in implementing new models of care and there are early signs of a positive impact on emergency admissions. But the evaluation is not yet complete and, while NHS England expects to achieve savings, the long-term impact and sustainability of vanguards is still not proven.
An important objective of the programme was to design new care models that could be replicated quickly across the NHS, and services have not yet been transformed to the depth and scale that was hoped for at the beginning of the programme. The Chief Executive of NHS England confirmed to us his commitment that NHS England will sustain and spread the vanguard new care models through a long-term plan. We look forward to seeing this carried through, so that NHS England breaks out of previous cycles of missed opportunity and delivers full value for money.
