Challenges facing community based care include: historical provision and gaps in service; multiple providers; fragmented pathways of care; long lengths of stay; delayed discharges; over reliance of hospital based palliative care; ineffective use of community facilities; challenges with workforce capacity and culture; perverse financial incentives; and poor data and information sharing.
Many services that are performing well now will not be sustainable without change, and redesign is essential to maintain and improve clinical safety and quality, recruit and retain a sufficiently skilled and experienced workforce, and maintain patient/user satisfaction. Some services could be centralised to provide better access to highly trained specialists but services also need to be accessed locally.
Achieving this kind of transformation with the funding that is available is not an easy undertaking. By working together, the NHS and social services, with other public, private and voluntary sector providers of care, can get the best possible outcomes for local people.
How we can provide support
We have extensive social and clinical subject matter expertise with a sensitive approach to collaborative working. Our methodology has been applied across a range of service areas including whole systems care planning, MSK rehabilitation and physiotherapy, orthopaedic triage, learning disabilities, primary care and reviews of contracting AQP and locally commissioned services. Our experience spans the whole spectrum of care: public health; primary care; secondary and community care; and tertiary care.