Implementing the New Care Models in the NHS: Reconfiguring the Multilevel Nature of Context to Make It Happen

This chapter derives lessons about reform in the UK’s National Health Service through the development of the Vanguard new care models programme. These new models of care proposed changes that are not concerned solely with structures or top-down reform edicts but are seeking new ways of working and joining up care across a whole system driven by those on the front line. Drawing upon recent theoretical developments on the multilevel nature of context, factors shaping the implementation of five Vanguard initiatives in the North East of England are explored. In so doing, this chapter aims to broaden the scope and scale of analysis across the multiple levels of context—at macro-, meso-, and micro-levels—shaping both process and outcomes of health systems transformation.