As the national new care models programme comes to an end, it is time to consider its legacy and ensure the lessons learned are shared with the rest of the health and care system. As part of the programme 50 vanguard sites across the country have made great strides in transforming health and care services in line with the ambitions set out in the Five year forward view. In order to do so, they have built relationships across historically fragmented systems, worked through complex contractual and governance arrangements, and explored innovative approaches to delivering care. They have also built on our understanding of how to engage staff, patients and the public in change, and how initiatives and successes can be most effectively spread across the health and care system.

This briefing series explores three crucial topics for the vanguards and offers practical examples from a number of the vanguard sites:

Learning from the vanguards: supporting people and communities to stay well explores how the vanguards have sought to design health and care services around the needs of people who use them, focusing on the outcomes that matter to people and tailoring care to their needs and goals. It also explores how the vanguards have adopted community- and asset-based approaches to consider the broadest possible influences on health and care.

Learning from the vanguards: staff at the heart of new care models looks at how the vanguards have broken down traditional organisational barriers across whole systems, how they have engaged staff in the programmes, communicated change and supported staff to work differently. The vanguards have demonstrated the positive impact that effective leadership and open, permissive cultures can have on motivating staff to lead and embrace change.   

Learning from the vanguards: spreading and scaling up change explores the ten key factors that the vanguards have identified are crucial to encourage the spread of initiatives. These include the importance of involving clinicians in change, building shared goals across systems, and creating the time, space and resources for large scale change. This briefing points to how the vanguards have benefited from the coordinated support of the arm's length bodies and their permission to 'fail fast and learn faster'. It also highlights how investing heavily in different ways of sharing learning, building networks and bringing people together, have been critical to the vanguards.  

Learning from the vanguards: improving the experiences of people who use services looks at what the vanguards have been doing to improve the way people experience and interact with health and care services, and shares the lessons that other organisations and partnerships can take from the vanguards’ experiences.

The new care models programme set out to design, test and deliver a variety of scalable and replicable new care models for the whole country. We hope these briefings will be a valuable resource for others who are working with partners in their local areas to redesign care to deliver transformational and lasting change. Sustainability and transformation partnerships (STPs), accountable care systems and accountable care organisations (ACOs) will be key vehicles for scaling up and spreading the models. In some areas, vanguards have evolved into one of these new models, or form a crucial component of it, and the vanguards have laid the groundwork for change on a larger scale. There is now an opportunity for STPs and ACOs to build on the vanguards’ understanding of what has – and hasn’t – worked, their leadership and momentum, and the expertise and energy of staff and local communities.