Aims of NHS vanguards not met, says NAO

The National Audit Office (NAO) has reported that NHS England’s vanguard programme has not delivered the depth and scale of transformed services it aimed for at the beginning of the programme.

The organisation’s latest report has found that finances originally intended to enable the initiative to transform services was instead spent on helping to relieve short-term financial pressures in the NHS by reducing trusts’ financial deficits, weakening its chances of success.

NHS England selected 50 sites to act as ‘vanguards’ to design new care models that could be quickly replicated across England, planning for £2.2 billion of funding for new care models between 2016-17 and 2020-21, but using much of the funding to reduce deficits faced by hospitals. Consequently, with less funding for transformation, the NAO says that the original intention to expand the programme was not realised.

However, vanguards have made progress in developing new care models and are set to make net savings. As at April 2018, it estimated that vanguards would secure £324 million net savings annually by 2020-21, which is 90 per cent of the £360 million that had been expected.

The NAO recommends that NHS England should strengthen its approach to transformation, by setting out what it has learned from the vanguard programme. The Department of Health and Social Care and NHS England should also consider setting out clear plans for transforming NHS services over the long term.

Amyas Morse, the head of the NAO, said: “The vanguard programme is one of a series of attempts to transform the NHS. Its progress has been mixed but there are some early signs of a positive impact. I am pleased that the Chief Executive of the NHS has confirmed to us his commitment to sustaining and spreading vanguard new care models through a long-term plan, and hope that NHS England can break out of previous cycles of missed opportunity.”

Speaking to the Giardina, Morse also said that there should be enough common ground across the political spectrum to find extra funding and form a new, united vision for health and social care in the 21st century.