Let’s hear about transforming care for the future

The work being carried out in ‘vanguard’ areas has significant implications for healthcare organisations. NHS England envisages that the new care models will provide a blueprint for the future NHS.

Vanguards have been tasked with making health services more accessible and effective by dismantling NHS care pathways that are no longer working well and taking a fresh approach to service design. Better communication and joined up working between GP and hospital services, emergency services and community-based organisations are integral to this new approach. This means joining up the confusing array of services so that patients know where they can get urgent help easily and effectively, seven days a week.

The new ways of working could see cancer and dementia specialists holding clinics in local surgeries, one point of call for family doctors, community nurses, social and mental health services, or access to blood tests, dialysis or chemotherapy closer to home. This has implications for already stretched primary care and needs financial investment and a workforce to meet the changes.  

Earlier this year I chaired an advisory panel involving eight vanguards where experiences, initiatives and objectives were shared. The subsequent report (Commissioning Excellence 2016) provides fascinating evidence of how NHS vanguards are redefining patient pathways and trialling new ways of working.

But with so many people affected by preventable conditions, such as diabetes and obesity, the focus of care needs to shift from managing ill health to preventing it, and to managing long-term conditions better.

This will require investment in strategies to enable earlier diagnosis and intervention. The articles on wound care (page 24) and childhood obesity (page 32) give examples of how service delivery can be transformed. 

The NHS needs an extra £30bn to deliver the Five Year Forward View. The Treasury promised £8bn pre-Brexit. The remainder has to come from doing things differently. Vanguards are part of this but there are other striking examples of how primary care can work differently that need to be shared. Primary Health Care highlights these through articles and news items. Write and share your practice with us. We want to hear how you are transforming services too.


Commissioning Excellence (2016) ‘The Role of Vanguards in the Development of New NHS Commissioning Structures’ NHIS. http://www.nhis.com/vanguard-report-2016



Sue Thomas

Associate Editor

Primary Health Care