The focus of NHS investment needs to shift from large acute hospitals to community and home-based services, according to the NHS Confederation.
A new report, Transforming Local Care, argued that “significant” investment in making the community the “default setting” of healthcare is needed to meet the combined pressures of increasing demand and shrinking budgets.
Hospital inpatient services can be reserved for complex surgery and treatment of life-threatening conditions, the report said – but major and visible improvements in community-based care need to take place at the same time.
The NHS Confederation, which represents commissioner and provider organisations, called for long-term condition management to be shifted decisively out of the hospital framework.
It highlighted the proven value of strategies such as home monitoring, mobile diagnostics and medication adjustment in helping to keep people out of hospital.
While these strategies were recommended by Lord Darzi’s NHS review in 2008, the “unprecedented” economic pressures have made them urgent priorities for national adoption, the report argued.
Calling on the NHS Commissioning Board to “facilitate the necessary shift in the financing of care”, the Confederation outlined the need for payment incentives to promote prevention, early intervention and early supported discharge.
Crucially, it added, efficiency savings must be reinvested in community-based services, instead of being claimed by the Treasury (as currently happens).
“It is time we started thinking differently and making sure investment supports innovative service delivery that supports patients’ independence and recovery,” said Jo Webber (pictured), the NHS Confederation’s interim Director of Policy.
“For too long, the default setting when we think about healthcare or support is to think of a hospital. But in reality, acute hospitals are rarely the best place for someone who needs ongoing treatment.”
