Scale and spread of innovation in health and social care: Insights from the evaluation of the New Care Model/Vanguard programme in England

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Abstract

Objective: Little is known about how to achieve scale and spread beyond the early local adoption of an innovative health care programme. We use the New Care Model – or ‘Vanguard’ – programme in the English National Health Service to illuminate the process, assessing why only one of five Vanguard programmes was successfully scaled up. Methods: We interviewed a wide range of stakeholders involved in the Vanguard programme, including programme leads, provider organisations, and policymakers. We also consulted relevant documentation. Results: A lack of direction near the end of the Vanguard programme, a lack of ongoing resources, and limited success in providing real-time monitoring and evaluation may all have contributed to the failure to scale and spread most of the Vanguard models. Conclusions: This programme is an example of the ‘scale and spread paradox’, in which localism was a key factor influencing the successful implementation of the Vanguards but ultimately limited their scale and spread.

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APA

MacInnes, J., Billings, J., Coleman, A., Mikelyte, R., Croke, S., Allen, P., & Checkland, K. (2023). Scale and spread of innovation in health and social care: Insights from the evaluation of the New Care Model/Vanguard programme in England. Journal of Health Services Research and Policy, 28(2), 128–137. https://doi.org/10.1177/13558196221139548

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