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A vision for the future of community-based health services

Why we did this project

There is a broad consensus that to achieve high-quality, sustainable health and care services that can meet the changing needs of the population, there will need to be a radical shift in the focus of care from hospital to community health services.

But despite a long history of policy initiatives – including Our health, our care, our say; High quality care for all and Transforming community services – and, more recently, the NHS five year forward view, there has not yet been a step-change in the focus of care delivery. Our recent work on general practice and district nursing has shown that the policy narrative about the need to transfer care from hospital to community health services is not being accompanied by a similar transfer of resource. In addition, as we highlighted in Social care for older people, cuts to social care services are having a significant impact on community health services.

Project content

What we did

Building on recent work around integrated care, place-based care, general practice and district nursing, we are beginning a new project to develop a vision for the future of community-based health services.

Our work had three key aims:

  • to describe the current state of community-based health services

  • to identify and bring together evidence-based best practice models of service delivery from the UK and internationally, and use these to identify design principles

  • to establish how to commission delivery models based on these best practice principles effectively.

Work included:

  • an analysis of national policy initiatives on community services over past 10 years

  • analysis of data including workforce, quality and outcome, activity and funding and identification of any gaps in the data

  • detailed analysis of the ‘map’ of community-based health services to examine current service-model configuration

  • interviews with providers and commissioners of community-based health services from across the country to determine how the map of services has developed and their thoughts on an ‘ideal’ map of services and barriers to delivering this

  • interviews with national bodies (including NHS England, NHS Improvement and the Care Quality Commission) to analyse current policy direction and challenges

  • literature search and analysis of published literature on best practice in community-based health services delivery

  • case study search and interviews with providers of best practice services (UK and international)

  • roundtable discussions with leaders in primary and community health services

  • workshops and/or focus groups with patients, carers and frontline staff.

Key milestones in community health services policy