Moving care closer to home

In Nottinghamshire, a solution is providing commissioners and healthcare providers with the evidence they need to establish whether patients are receiving the right level of care, at the right time and in the right setting.

The NHS has been warned that it must convince the public to let go of an outdated ‘hospital or bust’ model of medical care if improvements to the UK health service are to be realised. Senior health figures believe that at least a quarter of inpatients in NHS hospitals could be treated more effectively elsewhere, and that shifting resources into community-based services and nearer patients’ homes should be a major priority. The NHS Confederation says the health service should be concentrating on reducing hospital stays where this is right for patients, moving resources into the community setting and promoting early intervention and self care. The need to reassess healthcare delivery and build new NHS services around the needs of patients coincides with plans to develop an Integrated Care model in the UK that delivers greater interoperability between health and social care. Creating a more joined-up approach will significantly improve the patient experience and drive better health outcomes. In the process, effective integrated care should help take some of the strain off an over-burdened hospitalled system of care. But, in austere times, meeting the challenge is significant. How can individual health economies accelerate the journey towards integrated care – in the process, liberating hospital resources by shifting appropriate services into the community and improving patient outcomes? Finding the answer requires local health economies to undergo urgent real-time assessment of existing service usage, to identify gaps and bottlenecks in the system – and, based on the findings, develop appropriate community-based services that can help overcome them. The recommendations of the NHS Future Forum uses simple language to offer some basic advice to those charged with enhancing NHS service provision: you can only improve what you can measure. The journey towards designing patient-centric services must therefore begin with securing effective metrics to help stakeholders in health and social care make the right decisions in context. ‘Disruptive technology’ – an innovation that improves the product or service in a way that the market does not expect – will play a vital role. In some parts of the country, it already is.

Utilisation review