There has been no shortage of headlines this winter about the pressures in hospitals across the country. At a recent event at The King’s Fund, there seemed to be a consensus among national and local health service leaders, clinicians and service users that many of the solutions to these pressures lie in the community.
There was also agreement that the community does not just mean health and care services delivered in these settings, but a much wider range of assets spanning statutory services, voluntary and community sector organisations, private sector organisations, support groups, social networks, individuals and more.
Our new report Reimagining community services: making the most of our assets reveals the pressures that services in the community are under. But it also highlights a wealth of innovation and good practice. Voluntary and community sector organisations are often at the heart of these.
Pockets of progress
Many areas have introduced social prescribing schemes. Others have introduced integrated community teams that bring together teams of GPs, community nurses, geriatricians, pharmacists, mental health professionals, staff from local voluntary organisations and community navigators. These teams can deliver proactive support to people with complex health and care needs and connect them with local community resources.
Many of the examples highlighted in the report have voluntary and community sector organisations working at their core. For example, in Leeds, a local charity (Carers Leeds) has led efforts to bring together and coordinate local support services for carers.
The case studies in the report are examples of a future in which community resources spanning health, social care, the voluntary and community sector and communities themselves work together to improve the health and wellbeing of local populations.
However, these examples are confined to pockets of progress, rather than being reflected across the system as a whole. The challenge is to move beyond innovative projects towards widespread adoption of community-focused approaches to care.
A focus on people
Learning from the failure of previous attempts to reform community health services, the focus should be on improving services for patients and users rather than top-down reorganisations and structural change. Across all areas of the country, local leaders should work towards integration by building alliances between the NHS and its partners in local government, the voluntary and community sector and elsewhere.
The report calls for a shift in the focus of the health and care system - from one focused on acute hospitals and reactive care, to one where community-based care becomes the central focus of planning and provision at all levels.