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Vanguards have fallen short of expectations, says NAO

How have the new models of care fared?

National Audit Office (NAO) researchers say the vanguard programme has fallen short of its aims.

Some 50 vanguards set out to be exemplars of the new care models detailed in NHS England’s Five year forward view (2014). These models aimed to transform services and integrate health and social care.

According to the NAO, vanguards were hampered because money originally intended to fund transformation was instead spent on helping to relieve short-term financial pressures in the NHS by reducing trusts’ financial deficits.

NAO said NHS England’s early planning assumption was £2.2bn of funding for new care models between 2016/17 and 2020/21. Actual direct funding of vanguards was £329m over three years from 2015/16, with another £60m spent by NHS England on central support for vanguards.

However, there has been a positive impact on emergency admissions with indications that vanguard areas saw the number of emergency admissions to hospitals increase more slowly than non-vanguard areas, on average, compared with 2014/15.

NHS England forecasts that vanguards will make net savings of £324m annually by 2020/21, which is 90% of the £360m that had been expected.

The Health and Social Care Department expects NHS England to spread new care models, including those developed by vanguards, to 50% of the population by 2020/21.

Head of the NAO Amyas Morse said NHS England chief executive Simon Stevens had made a commitment to spread new care models through a long-term plan.

Further information

Developing new care models through NHS vanguards