Innovating care, closer to home: launching our new programme

For years, policymakers, clinicians and communities have envisioned a health and care system where more people receive safe, effective care in or near their homes. It’s an ambition rooted in what matters to people: being cared for in familiar surroundings, avoiding unnecessary trips and stays in hospital, and having services that wrap around their lives rather than the other way round.

'It’s an ambition rooted in what matters to people: being cared for in familiar surroundings, avoiding unnecessary trips and stays in hospital, and having services that wrap around their lives rather than the other way round.'

Yet, turning this ambition into reality has proved difficult. Hospital activity and funding have continued to rise while community services are overstretched and often overlooked. There are many reasons for this – from workforce shortages and funding constraints, to fragmented services and the complexity of changing entrenched models of care.

Less discussed in the failure to shift care closer to home is the role of technology and innovation. Historically, advances in technology have often reinforced hospital-centric models of care, contributing to what Lord Darzi described as the ‘right drift’ towards specialist, hospital-based services rather than the desired ‘left shift’ towards a focus on neighbourhoods, primary and community care settings, and communities themselves.

But what if this dynamic could be changed? What if the focus of innovation efforts – clinical, technological and organisational – was centred more purposely around bringing care closer to where people live?

Our goal is to understand not just what works, but also the practical steps, system changes and cultural shifts that allow innovations to thrive in primary and community care. This matters because of the very real human impact these types of innovations could have.

Imagine a person undergoing cancer treatment who no longer spends hours in hospital because their therapy can be safely administered closer to home. Or a person living with diabetes, for whom accurate home blood sugar monitoring and analytical tools can help predict and prevent hypoglycaemia before it occurs. Or someone living with COPD who, instead of frequent hospital trips, can monitor their condition at home and receive timely support from a community team.

When thinking about these, and other examples, it’s possible to see how bringing care closer to home could improve people’s experience, reduce exposure to risks associated with hospital stays, support self-management, and help tackle inequalities by making services more accessible. It could also ease pressure on hospitals, freeing capacity for those who most need specialist inpatient care.

'New ideas and products alone don’t deliver impact, they need to be implemented and used.'

But of course, new ideas and products alone don’t deliver impact, they need to be implemented and used. That means:

• Designing for the realities of community-based services, including workflows, workforce mix and the buildings and technology that support care delivery.

• Aligning incentives and pathways, so community teams aren’t asked to do more without support, and patients don’t experience fragmented care.

• Building skills and confidence in how to manage change, including how to work with people and communities to design solutions together.

• Ensuring appropriate support is in place for patients and caregivers.

• Embedding equity to ensure innovations reach those who benefit most, not just those who find it easiest to engage.

Our programme will explore these factors, reviewing the evidence, learning from sites on the ground and generating practical outputs, including bite-sized resources, toolkits and case studies to help leaders and teams adopt and adapt innovations in primary and community care.

Our horizon scanning

In the first phase of our programme, we’re horizon scanning to identify innovations with the greatest potential to reduce reliance on hospital-based care and improve people’s outcomes and experience. We’re especially interested in:

• innovations that shift activity from outpatient or inpatient settings into community or home environments

• approaches that simplify patient pathways and reduce time spent in hospital

• tools that support earlier diagnosis or proactive monitoring of long-term conditions in community settings

• models that strengthen multi-disciplinary care across neighbourhoods

• approaches that embed equity and are designed to reach underserved communities.