King’s Fund: shift to community health treatment must be improved

Government policies to increase the delivery of health services within the community are failing, health charity the King’s Fund has warned.

Several government initiatives have promoted the idea of providing health care closer to home, most notably the 2006 White Paper, Our Health, Our Care, Our Say. Recent evaluation of projects piloting community-based services have shown that they can provide the same quality of care as a hospital environment but at a lower cost.

But the King’s Fund said that the shift of health care from hospitals to the community remains patchy across the UK and that the public are “sceptical” of the benefits of receiving health care at home. The charity called for politicians and health chiefs to make a better case for the need to reform services.

The call followed the results of an innovative research project published this week. The SeeSaw Report, conducted by consultants Loop2 in conjunction with the King’s Fund, used 70 health professionals as “players” to simulate the commissioning process to attempt to predict what services would be purchased in the future. It was found that clinicians and managers were only concerned with “relatively small-scale improvements”, while commissioners were not sufficiently committed or able to secure a dramatic change in the pattern of care.

Niall Dickson, chief executive of the King’s Fund said: “At the moment it can be difficult for commissioners to shift more care to community settings when the incentives for change are not in place. But commissioners must get a more sophisticated grasp of the levers they can use to encourage providers to provide care differently.”

Report co-author Sarah Harvey said there was “great potential” to offer more care in people’s homes but that the NHS was not explaining the advantages of this to patients. “This may well be the most cost effective way of improving outcomes for people needing care,” she added. “This will require health, social care and housing services to develop even closer working relationships than exist currently.”

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