The report, which is based on the findings of a working group of community trusts convened by the Fund, argues that previous policy has failed to achieve this longstanding ambition. To address this, it sets out a seven-step plan for change, based on community services working much more closely with groups of general practices and building multidisciplinary teams to care for people with complex needs. This would reduce hospital admission rates, releasing resources for patients to be cared for at home and stemming growing demand for hospital beds.
The report argues that the scale of community services is poorly understood and not well served by the way the debate on health services is often dominated by ‘GPs and hospitals’ or ‘primary and secondary care’. However, it found a growing consensus about the important role of community services and the changes needed. The seven interrelated steps identified by the working group are:
- reduce unnecessary complexity of community services
- forge much closer relationships with groups of general practices
- build multidisciplinary teams for people with complex needs, including social care, mental health and other services
- support these teams with specialist medical input – particularly for older people and those with chronic conditions
- create services that offer an alternative to hospital stay
- build the information infrastructure, workforce, and ways of working and commissioning that are required to support this
- reach out into the wider community to improve prevention, provide support for isolated people, and create healthy communities.
Nigel Edwards, Senior Fellow at The King’s Fund said:
“There is an emerging consensus about the value of community services. Although some progress has been made, radical change is needed to realise the ambition of moving more care out of hospital and closer to people’s homes. With the health system under increasing pressure, especially the hospital sector, improving the effectiveness of community services is essential – it is time to bring community services from the margins to the mainstream.”