NHS England has launched the Acute Care Collaboration Vanguard Programme for smaller acute hospitals to develop and test innovative ways of delivering high quality acute care for patients.  Organisations and partnerships have until 31 July 2015 to submit an Expression of Interest in becoming a Vanguard site for new models of acute care collaboration. 

New models of delivery

These new Vanguard sites are being developed as part of the implementation of NHSE's Five Year Forward View (FYFV) and build upon the proposals contained in the Dalton Review.  The aim of this new wave of vanguards is to enhance the viability and sustainability of local hospitals by developing and testing new models of delivery including hospital 'chains' which might involve formal collaboration between clinical specialists at different hospitals, shared management and shared back office administration between different sites.
Applicants will be expected to "demonstrate how their proposals will help promote the health and well-being of the populations they serve, increasing the quality and person-centredness of care, and improve efficiency for the taxpayer within available resources".  Proposals may include providers who wish to:

  • deliver or manage elective services across different geographical sites;
  • share back office and/or clinical support functions; or
  • create multi-service chains or “foundation groups”. 

Smaller hospitals

Successful smaller hospitals are a central feature of NHSE's FYFV and a welcome alternative to traditional mergers and acquisitions within the NHS.  Due to their size and location, smaller acute hospitals experience different staffing and financial challenges than larger hospitals, but research conducted by Monitor in June 2014 demonstrated that there was no clear evidence that they performed any worse clinically than their larger counterparts.

All hospitals need to explore and implement new ways of working to ensure that services do not deteriorate and that they are financially and clinically sustainable.  New models of care delivery - hospital chains, shared management, clinical collaboration, satellite services and the integration of acute, community and primary care via PACS - provide exciting options which should help to improve the viability and sustainability of many smaller hospitals whilst recognising that one size does not fit all. 

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. 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.

On the one hand, there is a  need to find commercial and governance models to pool budgets and aligns incentives between primary, community and secondary care – and we are supporting the leading PACS and MCPs to do just this. But creating what then becomes the change agent for out-of-hospital care still leaves the need to find more effective ways to deliver acute care in-hospital – through new models of collaboration between clinicians and more effective back office functions.

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.
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.

Please contact Vincent Buscemi or Steve Hughes for further information or to discuss your plans without obligation.

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