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New models of care

New models of care are one of the three ways the Government is introducing integrated health and social care at a local level in England. If you are a member of nursing staff in England, you may already be working in one of the sites piloting a new model of care.

NHS England’s Five Year Forward View set out seven different new ‘models of care’.  

The NHS invited organisations and partnerships to apply to pilot these new models of care, which are now being delivered at over 50 sites under the Vanguard Programme. Integration Pioneers; integrated personal commissioning programmes; testbeds and internet of things testbeds are also being piloted.  


What are vanguards?

Vanguards are pilot sites for one of the new models of care and that already have existing arrangements and agreements for delivering services.

Where the vanguard sites will be

Vanguard sites are across England. Regional information is available here:

South East England
South West England
Eastern England
East Midlands
West Midlands
North West England

Information on developments in other regions of England will be available here soon.

How vanguards will impact nursing staff

Bringing health and social care closer together could have some benefits for staff.  

Nursing staff working in social care often face challenges, from overly burdensome bureaucracy to confusion over who or which agency is ultimately responsible for payment so  a coordinated approach could help to overcome those challenges.

All of the proposed models rely on the skills of a well-trained and resourced nursing workforce, as well as giving nurses opportunities to improve and increase their skills and capabilities. But the RCN is concerned that there may be a risk to terms and conditions.

Whilst there is currently funding attached to each vanguard site and each new model of care, it is unclear where this money is going to come from in the future. 

So far the evaluation of the vanguards has not been shared so it’s difficult to comment on their impact or value.

Many RCN respondents to a vanguard survey last year were unaware that they were now working at a vanguard site which raises questions as to how well front-line staff are being engaged in the programme.  

How the vanguards will impact patients

Patients could receive more coordinated care across primary, community and acute services.

Vanguards have also been focusing on addressing public health challenges like diabetes, smoking and alcohol. 

How nursing staff can influence vanguard sites

Nursing staff should be represented on all the bodies that are implementing and overseeing the Vanguard programme, such as their project boards, and clinical commissioning group clinical cabinets. 

You can contact your local RCN regional offices for more information.

Integrated care in England

Find out more about the three ways integrated health and social care is set to be delivered in England and what it all means for you.