The national NHS bodies in England launched the vanguard support package on Friday, revealing details of the support for local health systems to implement new models of care.
Further details of plans to merge GP funding with that of hospitals and even social care were also revealed.
Officials announced details of the first allocations of a £200m transformation fund used to support the vanguards, including CCG- and practice-led multispecialty community providers (MCPs) and hospital-led primary and acute care systems (PACS).
The initiative in Northumberland has been handed £8.3m to develop an accountable care organisation (ACO). Health bodies, including GP practices in the area, intend to launch the American-style ACO - an integrated provider-led body with a pooled budget - by 2017.
Elsewhere, NHS England announced £6.5m for the Better Health and Care for Sunderland system and £4.9m for the South Somerset Symphony Programme.
A further £41m is approved in principle for vanguards in Morecambe, Southern Hampshire, Isle of Wight, Salford and Wirral, to be finalised next month.
The new vanguard support package, developed through visits to all 29 sites, revealed that while 14 are already implementing extended GP access through the Prime Minister’s Challenge Fund, from next month all vanguards will begin exploring similar approaches.
‘The government has made seven-day working a top priority for the NHS in this parliament across all geographies, and the vanguards will have the opportunity to be at the forefront of this work,' the document said.
The document also revealed more details of plans for merged, whole population capitation funding for vanguards.
For the MCPs, which are based on the GP patient list, the document said: ‘The structure will build in additional community and mental health services and social care as appropriate, converting these into an amount per patient that can be combined with core general practice funding.’
Voluntarily merged funding for MCPs could go live from April 2016.
Practices will be offered ‘simple and attractive options to migrate from their current funding and contractual arrangements, including ways to enable "rights of return",' the document added.
For hospital-led PACS it said: ‘The idea behind a PACS is that there is a single local system of provision. The implication of that is for a PACS to take on a single capitated budget for all health care (and potentially social care) for their registered population.’
PACS will be supported to implement the new capitated approach as soon as practicable. PACS will also be allowed to make payments to outside providers, ‘enabling patient choice’.
Quality funding arrangements such as QOF and Commissioning for Quality and Innovation (CQUIN) could be simplified and aligned.
The Five Year Forward View leadership will publish a set of core metrics for evaluating the vanguards by October. For PACS and MCPs metrics will include emergency admissions per person, bed days per person and quality of life for people with long- term conditions.
NHS England chief executive Simon Stevens said: ‘Led by doctors, nurses and other staff, as well as patients and community groups, the vanguards are being asked to radically redesign the way they provide care. The support package has been designed with and for the vanguards. It provides them with additional tools to move at pace and, importantly, to remove barriers that stop them from delivering the best possible care to patients.’
GP partner at Handsworth Wood Medical Centre, part of the Vitality vanguard, Dr Nick Harding, said: 'We welcome the publication of the support package. It will help us to transfer more power to patients, to redesign our workforce, and to rethink how care is delivered by harnessing the benefits of digital and other technology.'