Moorfields in the vanguard of new NHS hospitals collaboration drive

Moorfields in the vanguard of new NHS hospitals collaboration drive

Moorfields Eye Hospital is one of 13 new hospital vanguards selected by NHS England to develop new models of care as part of the next stage of implementing the NHS Five Year Forward View.

Known as acute care collaboration vanguards they are designed to spread excellence in hospital services and management across multiple geographies and explore radical new options for the future of local hospitals across the NHS.

The new vanguards will receive financial and practical support, and learning from their experience will be used by other areas in coming years. This is part of a joint programme led by NHS England and NHS Improvement with other NHS Five Year Forward View partners.

The trust already runs services in 22 locations in and around London in a variety of healthcare settings, but recognises that this model has grown in response to ad hoc requests. Moorfields wants to identify the best approach to establishing and sustaining a chain of services and to produce a toolkit which can be used to roll out service level chains regardless of the specialty to benefit patients in other parts of the NHS.

In addition to analysing the best approach for a successful chain of services, the trust will also explore the opportunities and risks associated with running an extended network of eye services, based on increasing the number of Moorfields satellite sites and widening the trust’s geographic reach.

There are three new approaches that will now be tested, in response to ideas for reform that have been proposed by frontline clinicians and managers themselves:

A) Excellently-performing individual NHS hospitals able to form NHS Foundation Groups to raise standards across a chain of hospitals (a model of hospital 'chains' frequently used in other countries).

B) Individual clinical services at local District General Hospitals being run on site by specialists from regional centres of excellence (for example, orthopaedics, ophthalmology, and neurosciences). Also in this model, a smaller trust draws in expertise from larger and surrounding trusts through a mixture of both networking and franchises.

C) Forming 'accountable clinical networks' integrating care across District General Hospitals and teaching hospitals for key services, including cancer and mental health. As recommended by the recent independent Cancer Taskforce, the new cancer vanguards will work towards taking accountability for a population budget for cancer care, able to operate across sites, move investment into speedier early diagnosis, and optimising combinations of cancer surgery, radiotherapy and chemotherapy.

At a speech in London Simon Stevens, NHS England Chief Executive, will say: "The era of go-it-alone individual hospitals is now being superseded by more integrated care partnerships - both within local areas, and across different parts of the country. The scale of the interest in these new vanguards from across the health service shows the NHS is up for radical reform.

"Our new approach to hospital partnerships will help sustain the viability of local hospitals, share clinical and management expertise across geographies, and drive efficiency beyond the walls of individual institutions.

"We've got some of the world's best hospitals and specialists in this country, and it’s right they should be able to extend their reach more widely, as the vanguard programme will now allow them to do."

Ed Smith, the new chair of NHS Improvement (Monitor and TDA) said: "Today's new vanguards represent the evolution from the era of standalone hospitals, begun in the 1962 Hospital Plan for England, and reinforced by the creation of foundation trusts in the early 2000s. These were right at the time, but the economic and clinical circumstances facing the NHS are now different, and our response needs to evolve."

The 13 vanguards – chosen from 65 bids – will be:

Multihospital chains

• Salford and Wigan Foundation Chain
• Northumbria Foundation Group
• Royal Free London

Multisite specialty franchises

• Dartford and Gravesham (small District General Hospital making use of specialty franchises)     
• Moorfields (Ophthalmology)
• National Orthopaedic Alliance (Orthopaedics)
• The Neuro Network (The Walton, Liverpool) (Neurology and spinal specialty)

Accountable clinical networks

• MERIT (Mental Health Alliance for Excellence, Resilience, Innovation and Training) (Midlands) (Mental Health)
• Cheshire and Merseyside Women’s and Children Services (Maternity and Paediatrics)
• The Royal Marsden, Manchester Cancer and UCLH (Cancer)
• East Midlands Radiology Consortium (EMRAD) (Radiology)
• Developing ‘One NHS’ in Dorset (Multispecialty)
• Working Together Partnership (South Yorkshire, North Derbyshire and Mid Yorkshire) (multispecialty)