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Are hospitals the answer?

Pressures on the NHS are increasing, hospital beds are becoming harder to find and as the costs of hospital stays soar, it begs the question, are hospitals always the answer?

According to a new paper launching today, Improving the health of local people through community-based care, bringing healthcare into the community is the right answer to solve many of the problems the health service is facing today.

Healthcare at Home asked ZPB to curate and convene a cross-sector group of senior healthcare professionals, the Out-of-Hospital-Care Forum, and today we are publishing its findings. The paper is a practical guide for healthcare leaders to help them think through the opportunities and challenges of caring for people in their homes and communities. The first paper focuses on how community and home-based care can contribute to improved population health, put the patient at the heart of their care and potentially save STPs and ICOs money.

The aim of the Forum was to explore how community-based care can assist with managing the health of specific populations, which is illustrated in the paper through the lens of the frail elderly. The proposals can be used for any long-term condition including cancer and arthritis.

Some best practice examples include Abingdon Community Hospital, a provider of rehabilitation and palliative care. The integrated system includes nurses, occupational therapists, physiotherapists and hospital staff working closely with social services. The hospital’s transfer rate to acute hospitals stands at just four per cent.

In Dorset, the County Hospital’s Acute Hospital @ Home service provides patients with inpatient care in their own home in order to reduce acute medical admissions, facilitate early discharge and reduce the length of stay.

American primary care provider ChenMed is aimed at low-income older patients, with each GP managing around 400 people, who are all seen at least once a month. ChenMed claims to have reduced preventable hospitalisation by 30 per cent and the total cost of care by 20 per cent.

The paper also contains a useful checklist for systems to measure their progress on the journey to integrated care; and details of what leaders need to do to prepare including the role of commissioners; how to select patients; and answers to structural and money flow questions.

The Forum will be meeting again in July to build on this paper and look at the role of the workforce in integrated care. If you would like to learn more about the future of the Forum please email Dan Chapman.

Visit Healthcare at Home’s website to download the paper.