New Care Models Programme
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| New Care Models Programme | |
|---|---|
| Name | New Care Models Programme |
| Established | 2014 |
| Country | United Kingdom |
| Administered by | NHS England |
New Care Models Programme The New Care Models Programme was an NHS England initiative launched in 2014 to redesign health and social care delivery across England by testing integrated service configurations and payment reforms. It sought to link primary care hubs, acute hospitals, community services, and social care providers through a series of vanguard sites to demonstrate scalable pathways for population health management. The programme influenced subsequent policy instruments such as the Five Year Forward View, the Long Term Plan and combinatorial reforms involving Clinical Commissioning Groups, Integrated Care Systems, and novel contracting arrangements.
Background
The initiative emerged amid fiscal pressures associated with the 2010s United Kingdom political crisis over public spending and alongside structural changes affecting NHS England, Department of Health and Social Care, and Monitor (NHS) regulatory frameworks. Influences included reform agendas articulated in the Five Year Forward View authored by leaders from NHS England and the King's Fund, critiques from think tanks like The Nuffield Trust, and international models such as the Accountable Care Organization experiments in the United States and integrated care pilots in Sweden and Denmark. Pilot selection drew on clinical leadership from organisations including Royal College of General Practitioners, Royal College of Nursing, and integrated teams linked to trusts such as University College London Hospitals NHS Foundation Trust and Barts Health NHS Trust.
Objectives and Principles
Core objectives included reducing avoidable hospital admissions, improving population health outcomes, and delivering more cost-effective services through integration among Primary Care Networks, acute hospitals, community health providers, and local authorities. Principles emphasized multidisciplinary teams, risk stratification methods derived from NHS Digital data assets, preventive care pathways inspired by Population Health Management frameworks, and alignment of incentives via contracting reforms like capitated budgets and outcome-based payments referenced in financial policy documents from HM Treasury.
Implementation and Models
Implementation took place via designated "vanguard" sites representing models such as Multispecialty Community Providers (MCPs), Enhanced Health in Care Homes, and Acute Care Collaboratives. MCP pilots involved partnerships between general practice federations, community trusts like Central London Community Healthcare NHS Trust, and voluntary sector organisations including Macmillan Cancer Support and Age UK. Enhanced Health in Care Homes brought together care home operators, local authority adult social care teams, and specialist geriatric services from acute providers. Acute Care Collaboratives coordinated transfers between trusts such as Guy's and St Thomas' NHS Foundation Trust and ambulance services including the London Ambulance Service.
Evaluation and Outcomes
Independent evaluations were commissioned from institutions such as Nuffield Trust, The King's Fund, and academic groups at London School of Economics, University of Manchester, and University of Birmingham. Reported outcomes varied: some vanguards demonstrated reductions in emergency admissions and length of stay for targeted cohorts, while other analyses found limited short-term cost savings and challenges with attributing outcomes due to contemporaneous policies like tariff changes overseen by NHS Improvement. Metrics incorporated routinely collected data from Hospital Episode Statistics and outcome frameworks aligned to indicators used by Care Quality Commission inspections.
Funding and Governance
Funding combined transformational support from NHS England and matched local investment from Clinical Commissioning Group budgets, with capital and revenue streams drawn from central allocations approved by Department of Health and Social Care and monitored against spending controls set by HM Treasury. Governance arrangements established local programme boards including clinical leads from Royal College of General Practitioners, executive sponsors from foundation trusts, and representatives from Healthwatch England and local authorities, with oversight through national steering groups coordinated by NHS England executives.
Challenges and Criticism
Critiques highlighted variability in scale-up planning, weaker-than-expected evidence for cost reduction, and tensions between short-term operational pressures at trusts such as Birmingham Women's and Children's NHS Foundation Trust and longer-term transformation aims. Academics from King's College London and policy analysts at Institute for Fiscal Studies questioned attribution of outcomes given concurrent austerity measures and workforce shortages affecting organisations represented by the Royal College of Nursing and British Medical Association. Legal and contractual challenges arose around procurement rules managed by Crown Commercial Service and regulatory interfaces with Care Quality Commission oversight.
Legacy and Impact on NHS Policy
The programme informed the design of Integrated Care Systems and contractual innovations adopted in the NHS Long Term Plan, influencing commissioning practice within Clinical Commissioning Groups and successor arrangements. Lessons on data sharing, multidisciplinary governance, and population health approaches contributed to national guidance from NHS England and academic outputs from University College London and Imperial College London. The vanguard experience also shaped debates in Parliament and among advisers within Number 10 Downing Street about sustainable models for delivering care to ageing populations, and left a footprint in subsequent programmes such as the development of Primary Care Networks and wider integration efforts across England.