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Vanguard - Foundation for Change

Foundations for Change - end of programme report

The Foundation Healthcare Group Vanguard was a collaboration between Guy’s and St Thomas’ NHS Foundation Trust and Dartford and Gravesham NHS Trust that ran as part of NHS England’s New Care Models programme from April 2016 to March 2018. The Vanguard tested a collaborative approach to working in three clinical areas: cardiology, vascular and children's services.


Foundations for Change was published at the end of the Vanguard programme. It tells the story of the Foundation Healthcare Group, from the impetus behind the collaboration and vision, through to how it worked in practice, the lessons learned, and the creation of the Guys’ and St Thomas Healthcare Alliance.

The report highlights how the partnership has delivered real benefits at both of our trusts.  For example:

  • In 2017, over 850 patient appointments were held at Darent Valley Hospital rather than Guy’s and St Thomas’, enabling patients to receive care closer to home and saving more than 37,000 patient travel miles.
  • In the first year of Guy’s and St Thomas’ delivering Dartford and Gravesham’s procurement function, over £800,000 was saved. This is scarce resource that can be reinvested instead on direct patient care, staff training and development, or research.
  • The creation of new roles and the opportunities for working within a wider multidisciplinary network have enhanced professional development opportunities and supported staff recruitment and retention.

From a national perspective, the partnership has shown how trusts like Guy’s and St Thomas’ can step up to become a system leader, improving care and supporting the sustainability of health services more widely. 

Video: The Vanguard Journey Explained

Video: The Vision

Dartford and Gravesham NHS Trust and Guy’s and St Thomas’ NHS Foundation Trust and are working together as a Vanguard site for the new models of care programme. The model aims to allow the two trusts to collaborate and share information more effectively which will greatly improve patient experience and clinical outcomes, without the formal organisational change of a merger or acquisition.

Video: Education

Dr Jugdeep Dhesi, consultant physician at Guy's and St Thomas’ NHS Foundation Trust, talks about the ‘Proactive Care of Older People undergoing Surgery’ (POPS) service which is being run at Dartford and Gravesham NHS Trust due to the innovative Vanguard Programme.

Video: Patient and Public Engagement

Andrea Carney, patient and public engagement manager at Guy's and St Thomas’ NHS Foundation Trust, shares her thoughts on the importance of patient and public engagement within the context of the Foundation Healthcare Group Vanguard Programme.

Cardiology Consultant Speaks about Vanguard Programme

Dr Jagdip Sidhu, Cardiology Consultant at Dartford and Gravesham NHS Trust, explains the aims of the cardiology workstream within the Vanguard programme and progress made to date. This video was originally presented at the Vanguard Celebration and Showcase event held on 4 July 2017.