Raid on NHS vanguard budget 'shows GPs need long-term funding pledge'

Funding leached from 'vanguard' NHS integration schemes shows that general practice needs a long-term guarantee of investment, the BMA's top GP has warned.

In 2015, NHS England set out plans to invest more than £2bn in vanguard schemes that were meant to transform the NHS and deliver savings by integrating services including general practice, hospitals and community health.

But a report by the National Audit Office (NAO) says that the vanguard programme 'has not delivered the depth and scale of transformed services it aimed for' because much of its funding was instead used to plug financial deficits at hospital trusts. The report also highlights a 'pattern of initiatives being continually folded into a successor initiative, sometimes before their objectives are fully achieved'.

GPC chair Dr Richard Vautrey told GPonline that the raid on vanguard funding reinforced the case for a guarantee from NHS leaders that general practice will be a priority when decisions are made about how to use the £20.5bn funding increase by 2023/24 pledged earlier this month by the government.

Short-term funding

'As has repeatedly happened in recent years, funding intended to support and develop community based services has been lost and used to plug trust deficits,' the GPC chair said. 'It’s why GPs want to see recurrent and sustained increases in funding in the future rather than yet more piecemeal short-term schemes that seem to be here today and gone tomorrow.

'To properly deal with the growing needs of our patients we need government and NHS England to prioritise general practice when it comes to using the £20bn promised for a long-term plan.'

Despite funding for the schemes being diverted to cover deficits, the NAO report found that 'vanguards have made progress in developing new care models'.

Most of the vanguard areas plan to continue with the new care models they have developed, the NAO says. But there are 'risks to continued progress' such as underfunding, recruitment problems and an NHS financial system that works against the integration projects.

NHS savings

The report highlights early evidence that new care models implemented in vanguard areas had reduced demand on A&E, and projected annual savings of more than £300m - but warns it remains too early to confirm either of these impacts.

Head of the NAO Amyas Morse said: 'The vanguard programme is one of a series of attempts to transform the NHS. Its progress has been mixed but there are some early signs of a positive impact. I am pleased that the chief executive of the NHS has confirmed to us his commitment to sustaining and spreading vanguard new care models through a long-term plan, and hope that NHS England can break out of previous cycles of missed opportunity.'

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