Community services are key to the NHS. Why are they still marginalised? Chris Hopson

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Providing more care closer to home would improve the lives of patients – and ease the pressure on our beleaguered hospitals

The NHS is overstretched, underfunded, and short-staffed. Pressures are growing. The results were there for all to see last winter. Staff run ragged, patient discharges delayed, standards of care slipping. It’s the same story right across health and social care.

The good news is there is a plan to ease these pressures by providing more care closer to home, freeing up much-needed resources for the sickest patients. This plan draws together the right skills from different services so that the care people receive is carefully coordinated and tailored to their needs. It focuses on helping us all to stay well, and live independently. Who would argue with that?

Yet this is not a new plan. It’s actually been around in various guises, under different governments, for many years – most recently in the Five Year Forward View, which underpins a lot of NHS strategy today. The idea is to support and strengthen NHS community services, which currently employ around one-fifth of health service staff and account for 100m patient contacts in England every year. These include community and district nurses, physios, speech and language therapists, school nurses, podiatrists, sexual health services and end-of-life care.

In our new report, NHS community services: taking centre stage, we highlight examples of innovation and good practice which are transforming the way care is delivered, meeting the needs of local people, keeping them well, helping them live independently even with serious, complex conditions – and easing pressures on other services. It can be done.

Despite this, our survey showed that more than 90% of trusts thought the gap between funding and the demand for services will grow in the next 12 months.

It is bad news for people who have to wait longer – often lonely, anxious and in pain – for the care they need at home. It means delays for patients who could be discharged from hospital if the right treatment or rehabilitation were available. And it could mean that people are unable to die in the manner and place of their choosing.

No one is suggesting this will be easy to fix. NHS community services come in a range of shapes and sizes, with different approaches in different places. This diversity can be a strength – but the contract and tendering process is complex, and sometimes puts the NHS at a disadvantage. We need to seize the opportunities presented by the push for integrated care and the prime minister’s commitment to increase long-term health and care funding, and bring NHS community services centre stage.

  • Chris Hopson is chief executive of NHS Providers, the association of acute, ambulance, community and mental health services