Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event. Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development. This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being. More information is available online: www.expo.nhs.uk

1. NHS Five Year Forward View
Health and Care Innovation Expo
New care models – The Story so far
3 September
Samantha Jones, Director – New Care Models Programme NHS
England @SamanthaJNHS
Antony Tiernan, Engagement and CommunicationsDirector, New Care
Models Programme, NHS England @AntonyTiernan

2. NHS Five Year Forward View
• Published in October 2014
• A shared vision across seven
national bodies
• New care models programme key
to delivery
• Focuses on both NHS and care
services
2

3. The challenges we face
3
Radical
upgrade in
prevention
Health and
wellbeing
gap
1
New care
models
Care and
qualitygap
2
Efficiencyand
investment
Funding
gap
3

4. Multispecialty
communityproviders
moving specialist care out
of hospitals into the
community
Integrated primary and
acute care systems
joining up GP, hospital,
community and mental
health services
Acute care
collaboration
local hospitals working
together to enhance
clinical and financial
viability
Enhanced health in
care homes
offering older people
better, joined up health,
care and rehabilitation
services
Urgent and emergency
care
new approaches to improve
the coordination of services
and reduce pressure on A&E
departments
Five new care models
4

5. Clinical
engagement
Patient
involvement
Local
ownership
National
support
Our core values
5

6. Integrated primary and acute care systems(PACS)
1 Wirral Partners
2 Mid Nottinghamshire Better Together
3 South Somerset Symphony Programme
4 Northumberland Accountable Care Organisation
5 Salford Together
6 Better Care Together (Morecambe Bay Health Community)
7 North East Hampshire and Farnham
8 Harrogate and Rural District Clinical Commissioning Group
9 My Life a Full Life (Isle of Wight)
Multispecialty communityproviders (MCPs)
10 Calderdale Health and Social Care Economy
11 Erew ash Multispecialty Community Provider
12 Fylde Coast Local Health Economy
13 Vitality (Birmingham and Sandw ell)
14 West Wakefield Health and Wellbeing Ltd
15 Better Health and Care for Sunderland
16 Dudley Multispecialty Community Provider
17 Whitstable Medical Practice
18 Stockport Together
19 Tow er Hamlets Integrated Provider Partnership
20 Better Local Care (Southern Hampshire)
21 West Cheshire Way
22 Lakeside Surgeries (Northamptonshire)
23 Principia Partners in Health (Southern Nottinghamshire)
Enhanced health in care home
24 NHS Wakefield Clinical Commissioning Group
25 Gateshead Care Home Project
26 East and North Hertfordshire Clinical Commissioning Group
27 Nottingham City Clinical Commissioning Group
28 Sutton Homes of Care
29 Airedale and partners
37 vanguards developing their visions locally
6
Urgent and emergency care (UEC)
30 Greater Nottingham Strategic Resilience Group
31 Cambridgeshire and Peterborough Clinical Commissioning Group
32 North East Urgent Care Netw ork
33
Barking and Dagenham, Havering and Redbridge System
Resilience Group
34 West Yorkshire Urgent and Emergency Care Netw ork
35 Leicester, Leicestershire & Rutland System Resilience Group
36 Solihull Together for Better Lives
37 South Devon and Torbay System Resilience Group

7. What will success look like?
• Nationally replicable models
• More accessible,more responsive and
more effective health, care and support
services
• Fewer trips to hospitals
• Care closer to home
• Better co-ordinated support
• 24/7 access to information and advice
• Access to urgent help easily and
effectively, seven days a week
7

8. • Leadership and organisational
development
• Workforce
• Commissioning and contracting
models
• Evaluation
• Information management
and technology
8
Common challenges across all sites

9. • Support package published in
July for the first 29 vanguards ards
• Developed following extensive
engagement, including two-day
visits to all sites
• Led by vanguards alongside national experts, the support package
will help them implement change effectively and at pace
• It is also intended to maximise sharing of learning and practice
across vanguards and with the wider NHS and care system
• Four design principles – we solve problems through joint national and
local leadership; we create simple replicable frameworks; we
encourage and support radical innovation; we work and learn at pace
9
Support package launched

10. Addressing the key enablers of transformation
1. Designing
new care
models and
enabling
spread
2. Evaluation
and metrics
3. Integrated
commissioning and
provision
5.
Harnessing
technology
6. Workforce
redesign
7. Local
leadership
and delivery
8. Communication
and engagement
NATIONAL
COHORT
LOCAL
4. Empowering
patients and
communities

11. 11
1. Designing a
new care
model and
enabling
spread
2. Evaluation
and metrics
3. Integrated
commissioning
and provision
4. Empow ering
patients and
communities
Integrated commissioning and provision – assistingthe
vanguards to break down the barriers which prevent their local
health system from developing integrated commissioning
Providing a package of support
Designing new care models – working with the vanguards to
develop their local model of care, maximising the greatest impact
and value for patients
Evaluation and metrics – supporting the vanguards to
understand – on an ongoing basis – the impact their changes
are having on patients, staff and the wider population
Empowering patients and communities – working with the
vanguards to enhance the way in which they work with patients,
local people and communities to develop services

12. 6. Workforce
redesign
7. Local
leadership
and delivery
8. Communication
and engagement
Providing a package of support
5.
Harnessing
technology
Harnessing technology – supporting the vanguards to rethink how
care is delivered, given the potential of digital technology to deliver
care in radically different ways. It will also help organisations to
more easily share patient information
Workforce redesign – supporting the vanguards to develop a
modern, flexible workforce which is organised around patients and
their local populations
Local leadership and delivery– working with the vanguards to
develop leadership capability and learn from international experts
Communications and engagement – supporting the vanguards
to demonstrate best practice in the way they engage with staff,
patients and local people

13. • 10 workstreams – led by a vanguard leader
and national expert – will work with the
vanguards to refine what is being offered
so that it is fully tailored to their needs
• In addition, vanguards have access to a
£200m transformation fund
• Vanguards have been given the opportunity to submit bids for funding (value
propositions) which demonstrate how they will help close the Forward View’s
‘three gaps’ – health and wellbeing; care and quality; funding gap
• Vanguards are demonstrating through their bids how they will deliver the
additional efficiencies by the end of 2017/18
• In July 2015, we announced eight vanguards would receive £61m between
them. Funding for other vanguards to be approved shortly
• Support for newer vanguards – acute care collaboration and urgent and
emergency care – will be published in November
13
Support for vanguards

14. • In May, the Forward View partners
announced plans for an additional wave of new
care model vanguard – known as acute care
collaborations
• Acute care collaborations will link together
local hospitals to improve their clinical
and financial viability
• Applications to become an acute care
collaboration closed on 31 July with
65 organisations and partnerships applying
• A shortlist will be drawn up in late August,
with a final decision on the successful
applicants to be made in September
• The successful vanguards will be selected following a rigorous process,
involving workshops and the engagement of key national and regional
partners and clinical and patient representative groups
Acute care collaboration vanguards

15. More details can be found on the
NHS England website:
www.england.nhs.uk/vanguards
Or join the conversation on Twitter
using the hashtag:
#futureNHS
Further information…
15

16. 16
Key elements of support:
1. Local care model design – analytical support segmenting populations and identifying
interventions; and, access to NHS England’s Right Care programme
2. Ongoing development and implementation – action research to evaluate the impact of
new care model components; and, clinical expertise and advice from new care model
clinical associates, and NHS England’s medical directorate clinicians
Vanguards will be supported to design and implement their overarching care
model based on population needs, and to understand the key components of
their care model which add the greatest impact and value for patients
1. Designing new care models

17. 17
Key elements of support:
1. Development of logic models as a foundation for development – intensive one-to-one
support on logic model development
2. Evidence-based interventions – evidence summaries produced for the interventions
being implemented through each care model
3. The vanguard approach to evaluating new care models – task and finish groups to
focus on areas of common challenge; a senior responsible officer for evaluation; and, co-
produced evaluation strategies
4. Core metrics across the care models – a core set of metrics for each care model; a
standardised approach to measuring patient experience; and, a standardised dashboard for
each vanguard to show progress against the metrics
Vanguards will be supported to develop evidence-based interventions.
Impact assessment and improvement will be established from common local
metrics and evaluation which identify the ingredients of each care model
2. Evaluation and metrics

18. 3. Integrated commissioning and provision
18
Key elements of support:
1. Capitated pricing – small number of new payment and incentive models that can be
implemented locally; budgetary flexibility of merging separate provider funding streams into
single pot; expertise on implementing new capitation approaches
2. Quality payments – new pay-for-performance schemes developed; co-design of a limited
menu of options
3. Bundled contracts, integrated commissioning and procurement – new standard MCP
contract and PACS contracts
4. Model provider-to-provider sub-contract – new model sub-contract; non-mandatory
model alliance agreement; access to legal advice provided for existing projects
5. Integrated commissioning – establishment of the new care models commissioning group;
practical support to manage integrated commissioning
6. Options for new integrated organisational forms – support to understand options, risks
and benefits; centrally commission legal advice to cover relevant issues
New integrated commissioning approaches will allow vanguards to deliver
care collaboratively designed around the whole needs of patients. These will
provide opportunities for capitated payment through new standard contracts

19. 19
Key elements of support:
1. Personalised care and empowering choice – support in developing partnerships with
voluntary organisations; advice on personal budgets
2. Expert advice to support vanguards to meet six principles – developed by the Five
Year Forward View People and Communities Board
3. Directory of support – publishing a comprehensive directory of national and local services
available to vanguards
Vanguards be supported to work in partnership with patients, people and
their community, empowering them and enabling choice through
personalised budgets, care planning and peer support
4. Empowering patients and communities

20. 20
Key elements of support:
1. Connected digital solutions and information systems – dedicated technical support to
develop local integrated care records; interoperability handbook
2. Information governance – practical help to develop information sharing agreements and
guidance on information governance
3. Digital strategy – diagnostic support to map digital resources; expertise to define digital
priorities and strategies; advice to select the right digital solutions
4. Managing system vendors – support to collate technology requirements and enable
collective market engagement and procurement at scale
Vanguards will be supported to develop connected digital solutions and
provided with expertise to unblock information governance barriers,
accelerating the use of data and technology locally
5. Harnessing technology

21. 21
Key elements of support:
1. Local workforce strategy – self-assessment tool on capacity and capability for workforce
redesign; support to develop plans for delivering local strategies
2. New and extended roles, skills and training - common skill descriptors and job
descriptions developed for new and extended roles; support to develop specific roles;
training resources
3. New ways of working - resources to support multi-disciplinary working, mental health
crisis care transformation and person-centred community care; facilitated simulation
exercises to understand the challenges of multi-professional working; peer learning sets
Vanguards will be supported to map and profile their existing workforce, develop new
and extended roles and new ways of working which support multi-disciplinary team
working and shared responsibility
6. Workforce redesign

22. 22
Key elements of support:
1. System leadership – Community of Practice leadership programmes; and, learning on
system leadership from international partners
2. Integrated and flexible leadership – leadership programmes to support specific needs;
learning community for primary care and community professionals; and, multi-disciplinary
learning sets
3. Leadership at all levels – exploration of ways to access leadership schemes for clinical
and non-clinical staff
4. Supporting local delivery – programme planning and project management approaches;
dedicated account manager for each vanguard; and, access to funding for set-up
5. Use of local health and social care assets – best practice roadmap for estates
management; surgery sessions; framework on how to rationalise estate across partners;
and, advice/legal support to deal with legacy of private finance initiative (PFI) deals
Vanguards will be supported to strengthen system leadership across all organisations,
distributingand empowering leadership at the frontline and creating clinical and
professional leadership which embraces integration
7. Local leadership and delivery

23. 23
Key elements of support:
1. Communications and engagement strategy – expertise to develop communication and
engagement strategies; and, new evaluation tool to enable vanguards to assess and
compare the impact of their strategy
2. Sharing best practice and methods – range of tools to share the learning as part of a
detailed collaboration plan; and, online tool to enable rapid dissemination of learning across
the vanguards
Vanguards want to develop effective local communications and engagement
which strengthens local collaboration with staff, local people and other
stakeholders. Vanguards will be provided with expertise and resources to
deliver local best practice
8. Communications and engagement