Closer to home?
The pledge: “By 2035 the majority of outpatient care will happen outside of hospitals”1
Hopes are pinned on around 200 new neighbourhood health centres to reduce pressure on hospitals in England.2 These could open 12 hours a day, six days a week. Teams of doctors, nurses, pharmacists, and other health professionals—often under one roof—will offer a “full range” of convenient health services including GP appointments, diagnostic tests, scans, blood tests, postoperative care, mental health support, and rehabilitation. Community health workers and volunteers will also provide services such as debt advice and employment support.
What’s the evidence?
The plan says schemes like doorstep community outreach can detect early signs of illness and reduce pressure on GPs and emergency departments. In Derby, integrated teams led to 2300 fewer category 3 ambulance callouts and 1400 fewer short hospital stays among people aged over 65 in a year.
How will it happen?
Two new contracts will be rolled out from next year to encourage GPs to work over larger geographies and lead new neighbourhood providers. There will be new financial incentives to drive the “neighbourhood health service.” It will lead on prevention and support people to be active participants in their own care. Under a new standard, 95% of people with complex needs will have an agreed care plan by 2027. Over the life of the plan, the share of expenditure on hospital care is predicted to fall, with proportionally greater investment in out-of-hospital care. Labour pledges to “deliver this shift in investment over the next 3 to 4 years as local areas build and expand their neighbourhood services.”
What’s the reaction?
Experts have long supported moving care to community settings and many welcome the government’s ambition. But there are questions about how the new centres will be funded and staffed amid severe system pressures, …
