A new report suggests that a more strategic role for ‘traditional’ community hospitals might be timely within the NHS in England.
According to research by RAND Europe, the European Observatory on Health Systems and Policies, and Bournemouth University, community hospitals could play a more active role in meeting the challenges facing the NHS, in particular in larger hospitals. This includes easing pressures on A&E and servicing people with long-term conditions. Currently 15 million people in England have a long-term condition, which takes up 50 per cent of GP visits, 70 per cent of the days patients spend in hospitals and 70 per cent of the overall NHS budget.
The study, funded by the National Institute for Health Research (NIHR), is against the background of an increased focus on shifting services closer to people’s homes and delivering more integrated care locally. However, there is no defined role for community hospitals in the English health service, with many largely responding to the needs of larger hospitals. At present, there are around 300 community hospitals in England, 219 of which have beds. A number of community hospitals have faced closure during the past ten years, and some still face uncertain futures.
The study highlights a number of lessons for NHS England on how to incorporate community hospitals into the English health system based on comparable models in five other countries – Norway, Finland, Italy, Australia and Scotland.
The report notes that community hospitals are able to provide a wide range of services, covering the entire spectrum of care provision, from preventative and primary care, through to inpatient and outpatient medical and surgical care. It highlights evidence of improved patient experience and satisfaction associated with community hospitals, while staff valued key aspects of the service, including its ease of access and sense of ‘homeliness.’
However, the often remote location of community hospitals means it can be difficult to attract and retain staff, and maintain a diverse employee skill-set. Infrastructure and IT can also be a challenge, particularly where community hospitals are seeking to deliver integrated care. In addition, the cost-effectiveness of community hospitals is not clear, and the current evidence base remains limited.
The full report is available here: https://www.journalslibrary.nihr.ac.uk/hsdr/hsdr05190/#/abstract