Health & Social Care Reform and the NHS 5yr Forward View: reconfiguration, integration and new care models in the East Midlands





Health and social care in England is going through a period of significant change. A range of national programmes are changing the way services are delivered, to align every-day practice with the vision set out in the five year forward view (5YFV)

While there is national direction and oversight of these programmes, how they work in practice will be determined locally. Key stakeholders including those from the Third sector; the voluntary community and social enterprise sectors, need to engage in and influence these programmes as they develop.

The 5YFV covers a number of themes, such as the importance of public health and ill-health prevention, empowering patients and communities, strengthening primary care and making further efficiencies within the health service.

National programmes

New care models - ‘vanguard’ sites

Success regimes

Integration Pioneers

Integrated personal commissioning (IPC)

The prime minister’s GP access fund (formerly known as the prime minister’s challenge fund)
Special measures

Diabetes Demonstrator sites



What's happening in the East Midlands?

The new care models 'vanguard' sites

The theme receiving most attention is the new models of care. Seen as one of the first steps for delivering the shared vision for the future of the NHS in the five year forward view (5YFV) the new care models programme supports the improvement and integration of NHS Services.

The divide between primary care, community care and care in hospitals is seen increasingly as a barrier to coordinated services. While developing strategic plans across local areas is not new, new care models are being actively promoted across England to develop blueprints that can be adopted across the rest of the health and social care system. The models aim to break down the artificial divides between different parts of the health service, as well as between the NHS and social care.

(please click on the headings for more information about each vanguard) 

Mid Nottinghamshire Better Together
This is one of nine primary and acute care system vanguard sites across England.  It is a partnership between:

  • Mid Nottinghamshire CCGs;
  • Aspirant Accountable Provider Alliance;
  • Voluntary sector special purpose vehicle (three district council CVSs);
  • General practice provider clinical cabinet (facilitated by the LMC)
  • Nottinghamshire County Council. 

Health and Social Care Services across Mid-Nottinghamshire have joined together to develop the Better Together programme. The better Together programme board includes a Voluntary Sector Special Purpose Vehicle of three District Council CVS’s: Ashfield Voluntary Action, Mansfield CVS and Newark & Sherwood CVS. This model in particular is intended to redefine the relationship between primary and secondary care.

Wellbeing Erewash 

This is one of fourteen multispecialty community provider vanguard sites across England. It is a partnership between:

  • Derbyshire Community Health Services NHS Foundation Trust;
  • Derbyshire Healthcare NHS Foundation Trust;
  • Erewash GP provider company;
  • Derbyshire Health United;
  • NHS Erewash CCG.

In February 2016, NHS England launched a new three year programme to support social movements in health and care. Working initially with 6 new care model vanguards across England, this programme will develop, test and spread effective ways of mobilising people in social movements that improve health and care outcomes and show a positive return on investment.

As part of this, Wellbeing Erewash are aspiring to create sustainable self-support systems and mechanisms by 2020 to enable its communities to make health and life-changing decisions.


Lakeside Healthcare (Northamptonshire)
This is one of fourteen multispecialty community provider vanguard sites across England. It is a partnership between:

  • Kettering General Hospital NHS Foundation Trust;
  • Peterborough and Stamford Hospitals NHS Foundation Trust;
  • University Hospitals of Leicester NHS Trust;
  • Northampton General Hospitals NHS Trust;
  • Northamptonshire Healthcare NHS Foundation Trust;
  • Northamptonshire County Council;
  • Corby Town Council;
  • Celesio (Lloyds Pharmacy);
  • Lakeside Healthcare GP “super practice”;
  • Local social service providers;
  • Voluntary and community sector. 

By working in close partnership and collaboration with several local NHS providers, key elected authorities, local social service providers and the voluntary and community sector, Working in multidisciplinary teams, Lakeside Healthcare plans to offer a number of new services including, ‘extended primary care services’ to most patients; providing convenient care every day of the week.


Principia Partners in Health (Southern Nottinghamshire)
This is one of fourteen multispecialty community provider vanguard sites across England. It is a partnership between:

  • Rushcliffe GP practices;
  • Rushcliffe community services providers; 
  • Rushcliffe CCG;
  • Principia Partners in Health community interest company.

GP practices in Rushcliffe have come together to establish  a new and unique primary care partnership and organisation, which will lead on and own the transformation of general practice. The new model of integrated care is focussed on early intervention, living well at home and avoiding unnecessary use of the hospital. Care will be delivered closer to patients’ homes resulting in an enhanced experience and improved clinical outcomes, and better use of available resources. 


Nottingham City Clinical Commissioning Group
This is one of six enhanced health in care homes vanguard sites across England. It is a partnership between:

  • CityCare Partnership;
  • Nottingham University Hospitals NHS Trust;
  • Nottinghamshire Healthcare NHS Trust;
  • Nottingham City Council;
  • AgeUK Nottingham;
  • Nottingham City CCG. 

The proposed new model will provide a structured and pro-active approach to care, complemented by a number of local innovations and will build on work already initiated with acute trusts, care homes and community services to develop a ‘pull’ approach to acute discharges, ensuring that social services are involved at the earliest opportunity

See also Inside: Nottingham City Vanguard Programme Improving care for older people


Greater Nottingham System Resilience Group
This is one of eight urgent and emergency care vanguard sites across England. It is a partnership between:

  • Nottingham University Hospitals NHS Trust;
  • South Nottingham and Erewash CCGs;
  • Nottingham City and County Councils;
  • East Midlands Ambulance Service;
  • Nottingham CityCare Partnership;
  • County Health Partnership;
  • Nottinghamshire Healthcare NHS Foundation Trust;
  • Derbyshire Health United Ltd;
  • Nottingham Emergency Services;
  • Health Watch Nottingham and Health Watch Nottinghamshire.

The vanguard will support ambitious improvements in urgent and emergency care for the citizens of South Nottinghamshire. Partners will look at what more they can do, using innovative workforce solutions to ensure that people receive care in a timely way and closer to home – in many cases avoiding the need for assessment or admission to hospital.


Leicester, Leicestershire & Rutland System Resilience Group
This is one of eight urgent and emergency care vanguard sites across England. It is a partnership between:

  • Leicester City CCG;
  • East Leicester and Rutland CCG;
  • West Leicestershire CCG;
  • Leicester County Council;
  • Leicester City Council;
  • University Hospitals of Leicester NHS Trust;
  • Leicestershire Partnership NHS Trust;
  • East Midlands Ambulance Service;
  • Other local organisations.

The Vanguard will create a new alliance-based urgent and emergency care system where all providers work as one network. This will bring together ambulance, NHS111, OOH and Single Point of Access services to ensure that patients get the right care, first time.


East Midlands Radiology Consortium (EMRAD) (Radiology)

This is one of thirteen acute care collaboration vanguard sites across England. It is a partnership between: 

  • Nottingham University Hospitals NHS Trust;
  • Chesterfield Royal Hospital NHS Foundation Trust; 
  • Kettering General Hospital NHS Foundation Trust;
  • Sherwood Forest Hospitals NHS Foundation Trust;
  • Northampton General Hospital NHS Trust;
  • University Hospitals of Leicester NHS Trust;
  • United Lincolnshire Hospitals NHS Trust.

East Midlands Radiology Consortium (EMRAD) is a consortium of seven NHS trusts within the East Midlands working together, hosted by Nottingham University Hospitals NHS Trust. Together they aim to create a clinical network, providing timely and expert radiology care for patients across the East Midlands regardless of their location 

 East Midlands Radiology Consortium (EMRAD) Youtube


Working Together Partnership (South Yorkshire, Mid Yorkshire, North Derbyshire)
This is one of thirteen acute care collaboration vanguard sites across England. It is a partnership between: 

  • Barnsley Hospital NHS Foundation Trust;
  • Chesterfield Royal Hospital NHS Foundation Trust;
  • Doncaster and Bassetlaw Hospitals NHS Foundation Trust;
  • The Mid Yorkshire NHS Trust;
  • The Rotherham NHS Foundation Trust;
  • Sheffield Children’s NHS Foundation Trust;
  • Sheffield Teaching Hospitals NHS Foundation Trust.

The Working Together Partnership is an existing partnership established in March 2013 between seven acute trusts in South Yorkshire, Mid Yorkshire and North Derbyshire. The programme aims to develop a clinical strategy involving different models highlighted in the Dalton Review.

See also: 

Working Together Newsletter issue 1 jan 14.pdf

Working Together newsletter November 2014.pdf


To read more about the Vanguard programme visit our Introduction to the New Care Models – Vanguard Sites

The success regime

In June 2015, NHS England identified three challenged local health and care economies, including Essex, where the conditions necessary to change do not exist. The success regime is designed to address the systemic issues in these areas.

There are no areas in the success regime within East Midlands

Read the BMA briefing on the success regime


The Prime Minister’s Challenge Fund (GP access fund)


In 2014, the prime minister announced a new challenge fund to help improve access to general practice and stimulate innovative ways of providing primary care services. Across two waves, 57 pilots, covering over 2,500 practices, were chosen to test these new methods.

(please click on the headings below for more information about the Prime Minister's Challenge Fund in the East Midlands) 


Phase 1 Pilots

Transforming General Practice in Derbyshire and Nottinghamshire (Derbyshire and Nottinghamshire)

The pilot offers extended hours in centrally located hubs, seven days a week; patients access services via hubs in the area. There are new ways to access consultations: by phone, email, video; and telecare to help people to better manage conditions at home.

Phase 2 Pilots

Improving and integrating access in primary care in Leicester delivered through locality hubs

The GP practices within Leicester City identified a need to build a new environment for primary care provision based around four locality hubs situated within identified Health Needs Neighbourhoods (HNNs).


Find out more about the prime minister’s GP access fund

See also the Prime Minister’s Challenge Fund: Improving Access to General Practice First Evaluation Report: October 2015

Integrated Care Pioneers

In 2013, national partners asked local areas (NHS and local government together) to express an interest in becoming pioneers to act as exemplars, demonstrating the use of ambitious and innovative approaches to efficiently deliver integrated care. Following an independent selection process, 14 pioneer sites across England were announced in November 2013. The selection process was then repeated in the autumn of 2014, and a further 11 pioneer sites joined the programme in January 2015.

(please click on the headings below for more information about the Integrated Care Pioneers in the East Midlands) 

Wave 2 

Nottingham City

Partners include:

  • Nottingham City CCG;
  • Nottingham City Council;
  • Nottingham City Care Partnership;
  • Nottingham University Hospitals NHS Trust;
  • Nottinghamshire Healthcare NHS Trust;
  • Nottingham Emergency Medical Services (NEMS);
  • Nottingham City Homes.


Nottingham County

Partners include:

  • Nottinghamshire County Council;
  • Mansfield and Ashfield CCG;
  • Newark and Sherwood CCG;
  • Nottingham North and East CCG;
  • Nottingham West CCG;
  • Rushcliffe CCG;
  • Other local organisations.

Find out more about integrated care pioneers

See also Integrated Care Pioneers: one year one  and Integrated care pioneers – two years on


Integrated Personal Commissioning (IPC) Demonstrator Sites


In 2014, nine demonstrator sites were selected for the IPC programme to allow individuals, commissioners and the voluntary sector to blend comprehensive health and social care funding, allowing the patient to direct how it is used.

IPC is a new approach to joining up health, social care and other services at the level of the individual. It enables people, carers and families to blend and control the resources available to them across the system in order to ‘commission’ their own care through personalised care planning and personal budgets. In tandem, IPC also supports people to develop their knowledge, skills and confidence to self-manage through partnerships with the voluntary and community sector (VCSE), community capacity building and peer support.

(please click on the heading below for more information about the Integrated Personal Commissioning in Luton) 

Lincolnshire CCGs and Lincolnshire County Council are working together to explore different ways of caring for people with dementia and people with learning disabilities.


Lincolnshire County Council

NHS Lincolnshire West CCG

South Lincolnshire CCG

Lincolnshire East CCG

South West Lincolnshire CCG

Voluntary sector partners


Read more about integrated personal commissioning and also from the Local Government Association National Children & Adult Services Conference

Voluntary Voices has been selected as a partner to the Integrated Personalised Commissioning programme and is establishing a workstream on co-production with the Integration Pioneers. 

The Regional Voices website comprises useful information about IPC and what it can mean for the voluntary sector.

Diabetes Demonstrator sites

In December 2014, NHS England announced in the Five Year Forward View into Action planning guidance that it would establish a national Type 2 Diabetes Prevention Programme in partnership with Public Health England (PHE) and Diabetes UK. Seven demonstrator sites have been testing innovative approaches to programme delivery for the last year and this learning has shaped the final programme to get the best results for patients  

The programme launch coincides with PHE’s new national campaign, One You, which encourages people in midlife to take control of their health and make better lifestyle choices – helping them to prevent ill health and help them live well for longer.

First wave

In a phased approach 27 areas will open their doors to patients in the next few months and throughout 2016 including: 

  • East Midlands
  • North East Lincolnshire
  • Derbyshire

 Read more about the Diabetes Demonstrator sites on the NHS England website


Devolution of health and social care

There are no formal devolution deals in place at the moment in the East Midlands.

Read the Kings Fund briefing: Devolution: what it means for health and social care in England

Wellbeing East Midlands is the name of Regional Voices Health and Social Network in the East Midlands. 

*From the 1st October 2015 Regional Voices' Health & Social Care Networks in the East and East Midlands (formerly managed by OEM) are being managed by selfhelp UK

Please email  if you would like to join our Wellbeing East Midlands network or if you have any news, events or resources you would like to share with network members.

or you can contact Jayne Quantrill contact, Health and Wellbeing Coordinator Wellbeing East Midlands directly at  mobile telephone number: 07508490731 

  Regional Voices champions the work of voluntary and community organisations to improve health, well-being and care, across 
. Regional Voices is a partnership of nine regional networks. Together, we directly connect to over 25,000 voluntary and community organisations. Our coverage is broad, deep and well-established. Our vision is for a society where voluntary and community organisations are connected with decision-makers at all levels, able to influence policy and improve community health, care and well-being through better services.