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Uniting organisations and people to deliver new care models

Samantha Jones, Director of New Models of Care, NHS England

Their mission may just be starting but the vanguards are already thriving as they reduce pressure on health services while improving care quality, writes Samantha Jones.

In the vanguards, local people and health and care organisations are working together to design and deliver new care models.

While 50 vanguards are officially taking part in the programme, our ambition is for more than 50 per cent of the country to be covered by new care models by 2020-21.

Each vanguard has clear plans in place for managing demand more effectively across their local health system and to reduce costs, whilst at the same time improving the care provided to patients.

This includes reducing avoidable hospital admissions and bed days, releasing back office savings and improving prevention, self-care and the use of technology.

And the vanguards are really thriving. For instance, the kitchen at Stanborough Lodge care home in Welwyn Garden City is part of the fight to ease the pressure on hospitals.

East and North Hertfordshire Clinical Commissioning Group vanguard has funded additional training for staff working in the home to increase their skills in relation to improving the diet of patients and how to support people with dementia.

Each vanguard has clear plans in place for managing demand more effectively across their local health system and to reduce costs, whilst at the same time improving the care provided to patients.

A local GP has been linked to the home and a pharmacist is working with residents to ensure they only take the medication they need. In March there were no falls – before the scheme there were about eight a month.  Ambulance calls are down more than 30 per cent.

A Carousel clinic simply gives the patient the opportunity to see a range of health professionals the same day within their own GP surgery – offering a full day of specialist assessment, education and self-management skills.

Each clinic concentrates on different health areas. For example, Badgerswood and Forest Surgery in the Better Local Care (Hampshire) vanguard is running an innovative pilot focused on improving speed and accuracy in diagnosis in patients experiencing symptoms of breathlessness. The project is known as MISSION (which stands for Modern Innovative SolutionS in Improving Outcomes iN Chronic Obstructive Pulmonary Disease). 

So far, the outcomes have been extremely promising – 1,436 patient records have been screened and 460 identified as poorly controlled, with 23 of 86 attendees identified as having potentially severe asthma.

In terms of COPD, 108 patients have been seen in a rapid clinic and 30 patients in a severe clinic. This has already led to a reduction in GP and out of hours visits, as well as emergency department and hospital admissions, and plans are in place to replicate this model across the county.

We have already published the first in a series of common frameworks for those wishing to take up the new ways of working.

List of Samantha Jones articles in the Health Service Journal.

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18 October 2016
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