Supporting new NHS care models

The King’s Fund is working with NHS and care organisations to support the development of the new care models set out in the NHS five year forward view. This work has been commissioned by the new care models programme, which is a partnership of seven arms-length bodies, including NHS England, Monitor and the NHS Trust Development Authority.

A total of 50 vanguard sites across England have now been announced. These will take the lead in developing their new care models with the aim of providing blueprints and inspiration for the rest of the health and care system.

Community of practice

The King’s Fund is leading a community of practice for the nine integrated primary and acute care system vanguards which aims to develop thinking and share learning on the leadership and governance of these new systems, how to effectively engage medical leaders in their development, and how to deliver the necessary cultural change to support them.

The Fund will also run a small number of events with the national bodies bringing together all of the vanguards to share learning so far and establish connections across the sites.

Vanguard sites

Vanguards are developing a range of new governance and organisational approaches to support their efforts to develop new models of integrated care. Taken from our report on emerging innovations in this area, this page presents some of the different approaches being taken along with case studies of the vanguards leading these innovations.

Areas covered by the approaches

Approaches to contracting for the new services
Commissioners are deciding which budgets should be brought together and how they can be transferred to providers under a single contractual framework.

Partnerships and organisational forms among providers
Vanguard sites are considering which providers should hold the budget for services and how they should be organised to deliver more integrated services. They are exploring a range of options, including sub-contractor relationships, joint ventures or mergers.

Governance, decision-making and management of providers’ systems
Providers are starting to consider the governance and decision-making arrangements needed to manage care and quality effectively – for example, how to ensure that each partner delivers their commitments, how to promote effective joint working, and how to motivate teams and individuals to work differently.

Roles of commissioners in the new system
Commissioners are considering their future role in overseeing more integrated systems, including which activities they should continue to carry out and which to share with or transfer to providers.

Approaches to measuring and incentivising performance
As part of the contracting process, commissioners and providers are agreeing objective measures to assess the quality and outcomes of care. They are also considering options for motivating and incentivising performance.

Approaches being taken by some of the vanguard sites