Urgent and Emergency Care Vanguards

NHS England has launched the Urgent and Emergency Care Vanguard Programme following Professor Sir Bruce Keogh's Urgent and Emergency Care Review.  This latest vanguard programme will allow providers to develop and test innovative ways of delivering services aimed at achieving NHS England's vision for people with:

• urgent care needs to receive a highly responsive service that delivers care as close to home as possible and minimises disruption and inconvenience for patients and their families; and
• with more serious or life threatening emergency care needs, to be treated in centres with the very best expertise and facilities in order to maximise the chances of survival and a good recovery.

Organisations and partnerships have until 15th July 2015 to submit an Expression of Interest in becoming a Vanguard site for a new care model focussing on urgent and emergency care.

The current system

The current system of providing urgent and emergency care is often disjointed with no single point of access for service users and, as a consequence of that, service users are often confused about their choices in terms of provider. Do they attend their local GP or out of hours service, contact NHS 111, attend a minor injury unit or turn up at A&E? This confusion creates inefficiencies in the system and a can produce a negative effect on the efficient delivery of care for service users. It also puts unnecessary demand on A&E services and often leads to a sub-optimal patient experience. The Urgent and Emergency Care Review demonstrated that what is needed is a new model of care which is more joined up and which:

• provides better support for people to self-care;
• helps people with urgent care needs to get the right advice in the right place, first time;
• provide responsive, urgent health and social care services outside of hospital every day of the week;
• ensures that those people with more serious or life threatening emergency needs receive treatment in centres with the right facilities, processes and expertise in order to maximise chances of survival and a good recovery; and
• connects all urgent and emergency care services together so the overall health and social care system becomes more than just the sum of its parts.

New models of delivery

These new Vanguard sites are being developed as part of the implementation of NHSE's Five Year Forward View (FYFV).  The aim of this new wave of vanguards is to address current operational challenges by creating new models of delivery that cut across traditional organisational boundaries to improve the quality, productivity and efficiency of urgent and emergency care services as well as create a new sustainable and replicable model of care.

Applicants will be expected to explain their local vision for implementing the urgent and emergency care review with a view to creating a new system that will:

• deliver improved efficiencies, with patients reaching the right service first time, and with consequential financial savings being realised;
• deliver a reduction in the mortality rate where services such as stroke, cardiac and major trauma are provided round the clock in dedicated centres;
• improve the patient experience by establishing a new intuitive system; and
• configure services in such a way to deal with growing demand and an ageing population.

How we can help

Bevan Brittan is at the forefront of supporting organisations to deliver Vanguard and new models of care. We are advising six of the 29 PACS and MCP Vanguards and we are in discussions with a number of other organisations looking to develop new ways of working to deliver integrated and sustainable care including those organisations exploring the Acute Collaboration Vanguard model. We actively support organisations looking to work collaboratively to deliver services that place the person at the centre of their care by delivering through multi-disciplinary teams working across organisational boundaries.

We can support you and your partners by helping you to develop your application to NHSE as well as guiding you through the commercial, legal and governance arrangements that will be needed to deliver the changes envisaged in your new model. We have extensive experience of drafting and advising on urgent and emergency care contracts, out of hours contracts, NHS 111 contracts and contracts relating to minor injury units and urgent care facilities so we can also share the benefits of this experience with you. 

A number of the current Vanguards and other providers are creating corporate and/or commercial delivery vehicles to facilitate their objectives and to document agreed principles of engagement and collaboration.  We identify and provide strategic advice on the critical issues, such as procurement, competition, regulation and commercial contracting arrangements.  We are also tracking and logging issues and concerns "on the ground" to help provide a more effective framework for the assurance needs of commissioners, regulators and providers, and to facilitate solutions that support the ambitions of the FYFV.