Community Network

Pendulum must swing towards community care, say leaders

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NHS and local government leaders have spoken of the need to ‘hit reset’ on how care is delivered to ensure services better manage people’s needs in the community.

In a new podcast, leaders from the ambulance service, community health sector and social care express optimism that such a shift could propel a step change in how care is experienced across England.

But they warn it would only be achievable and sustainable if backed by the right policy levers, ‘grasping the nettle’ on social care funding and ensuring all the key decision makers in a ‘place’ are part of the decision-making process.

‘Tackled together’

“There is no financially sustainable service or NHS without a sustainable social care system, and vice versa,” says local government leader David Pearson. “This is absolutely the nettle that has to be grasped.”

Fellow podcast interviewee and NHS leader Matthew Winn agrees, saying: “I find it absolutely inconceivable and impractical for one part of health and social care to benefit and the other carries on in the extreme pressure they are having.

“They have to be tackled together, especially when it comes to integrated care around older people, people with long-term conditions, and children.”

‘Brave discussions’

On enablers other than social care funding that would facilitate greater emphasis on care closer to home, ambulance service leader Lena Samuels explains that having the right people as part of the decision-making process is key.

“One of the things I’ve found as we’ve gone around our various counties as we’ve had conversations with different STPs and other healthcare economies is that you don’t always have the right people around the table,” she explains.

“What we’ve been constantly doing is we’ve said we have needed to have the local council there and participating in the discussion because it’s got to be a seamless approach to each patient.

She added that “brave workforce discussions as systems” are also essential, “whereby we plan collectively together what we need right across those health systems rather than just for one aspect of it.”

Transforming care

The podcast, launched by the Community Network, spotlights the role of ambulance services, community health providers and social care in transforming care.

It comes as the Care Quality Commission’s latest review of the state of care in England concluded that for health and social care to be sustainable, there needs to be the “right provision in place and sufficient capacity to support people to stay well in the community or move smoothly through the system.”

And it follows health secretary Matt Hancock’s speech to the Conservative Party conference in October in which he declared the era of “moving all activity into fewer larger hospitals and blindly, invariably, closing community hospitals” over.

“I want more services closer to the communities they serve,” he said.

Exploring practical ways these services are already working across local areas to bring about change, the podcast debates the impact of social care funding, the health and care workforce, the role of technology, and the evolving health and care landscape.

The 13-minute interview features the views of Matthew Winn, chair of the Community Network and chief executive of Cambridgeshire Community Services NHS Trust; Lena Samuels, chair of South Central Ambulance NHS Foundation Trust; and David Pearson, STP and ICS lead for Nottingham City and Nottinghamshire and member of ADASS’ president’s team.

Changing care

It shines a light on several initiatives that are already changing how care is delivered, such Call for Care in Nottingham, a dedicated health and social care professional only phone line which arranges urgent, same-day interventions to prevent patient attendance or admission to hospital.

It has led to reductions in ambulance callouts, hospital admissions and length of stay, David Pearson explains.

And the primary care home model in Cambridgeshire, which is wrapping care, whether it be from a social care worker or community health nurse, around a designated and defined population based on the GP list.

This has enabled the local system to understand the needs of their population be really targeted in its approach, says Matthew Winn.

The podcast interview is chaired by the Dr Phil McCarvill, chief adviser at the NHS Confederation, on behalf of the Community Network.

The network is the national voice for NHS community services in England and has been established by the NHS Confederation and NHS Providers.

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