Intended for healthcare professionals


NHS long term plan: three new models of care that could be replicated across England

BMJ 2019; 364 doi: (Published 21 January 2019) Cite this as: BMJ 2019;364:l254
  1. Gareth Iacobucci, senior reporter
  1. The BMJ, London, UK
  1. giacobucci{at}

NHS England has mandated a nationwide roll-out of integrated care following promising results from pilot areas. Gareth Iacobucci went to Nottingham to hear about three schemes that the NHS wants to replicate

One of the flagship pledges in the NHS’s eagerly awaited long term plan,1 published on 7 January, was to create joined up integrated care systems in every area of England by April 2021. Local organisations from the NHS and local government will be expected to work more closely “in a pragmatic and practical way” to deliver the “triple integration” of primary and secondary care, physical and mental health services, and health and social care.

NHS England says almost everything in the plan is already “bearing fruit” somewhere, supported by its vanguard programme.2 It now wants pockets of innovation like these three schemes below to be spread across the country.

Enhanced care home support

What is it?

A package of general practice led enhanced support for older people living in care homes. Each care home is aligned with a local general practice, which provides regular visits from a named GP, improved support from community nurses, support from the third sector (Age UK), and a programme of work to engage and support care home managers.

It started in 2014 and continues to operate in 22 care homes across the Rushcliffe area of Nottingham.

What problems was it trying to solve?

The scheme set out to improve reactive, poorly planned care home support. The lack of continuity often led to delays and duplication, and the aim was to improve the quality of care to residents, especially those at the end of life, and increase residents’ involvement in decisions about their care.

The scheme sought to reduce the risk of falls, unnecessary transfers to emergency departments, and avoidable emergency admissions. It also targeted better use of …

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