Care moves into the community
Shifting care settings for many services away from hospitals and into the community can bring a number of benefits, such as better safety and experience outcomes for patients, and better outcomes for commissioners and providers in terms of more integrated services, greater efficiency and cost savings.
While certain medical services may be provided in big district general hospitals, more services will be provided in smaller clinics or through telehealth. Arguments in favour of care in the community include it is often cheaper, safer and more comfortable (due to the familiar setting) than hospital admission.
Shifting care into the community has already been the focus of recent health policies in the UK. There is growing evidence over the past decade to suggest that, under the right circumstances and situations, there are benefits to treating a patient in the community rather than hospital setting. Outcomes depend on the patient’s condition and quality of local community services but it can be particularly effective for older patients with chronic conditions. Studies indicate that implementing the chronic care model in the community is effective in improving clinical and behavioural outcomes, and can improve patient access. Patients feel more satisfied with the services they receive, and improved their knowledge of their conditions and treatments. Intermediate care, made up of services to help people stay at home or in a care home instead of being admitted or readmitted to a hospital, has established itself as a core component in the care for citizens.
However, while moving care settings for people away from the hospital can bring numerous benefits, there are also significant challenges that include implementation, integration of services, workforce management, and use of technology. There are also challenges to demonstrate reduce cost of care in these model of care.
Sources or references
- Interviews with healthcare professionals as part of the CfWI’s Medical and Dental Student Intakes project, 2012
- CfWI (2011) Integrated care for older people: Examining workforce and implementation challengesExamining workforce and implementation challenges
- The Health Foundation, 2011, Getting out of hospital?
- Royal College of Physicians, 2012, Care closer to home
- Piatt, GA et al., (2006) Translating the chronic care model into the comunity: results from a randomized controlled trial of a multifaceted diabetes care intervention, Diabetes Care
- NHS sustainability: moving care into the community, Health Service Journal
- Sibbald, B et al., 2008, Moving specialist care into the community: an initial evaluation, Journal of Health Services Research & Policy
Some of the information in this section is provided by stakeholders and expert groups, and does not necessarily represent the views of the CfWI.
