The Royal College of Physicians (RCP) has responded to an interview in the HSJ with Barts Health CEO Shane DeGaris in which he discusses the hospital-to-community shift from the 10 Year Plan.
While the move towards neighbourhood health has the potential to improve patient care and deliver more services closer to home, it must be underpinned by adequate investment, workforce capacity and clear plans to maintain safe hospital services during the transition.
The RCP has warned that shifting care out of hospitals without the right infrastructure, specialist input and community capacity risks increasing pressure elsewhere in the NHS rather than delivering the integrated, patient-centred care that patients need.
RCP clinical vice president Dr Hilary Williams said: ‘The RCP strongly supports the shift towards more care being delivered closer to home, but this must not come at the expense of safe, sustainable hospital services. Neighbourhood health can improve outcomes and patient experience by bringing together primary care, community services and medical specialists around people’s needs, particularly for those living with multiple long-term conditions. However, moving care out of hospital is not simply a question of relocating activity or funding.
‘Our work has consistently shown that successful neighbourhood care depends on proper planning, investment and integration. Specialist expertise must be embedded within neighbourhood teams, patients must have timely access to diagnostics and specialist support, and there must be clear clinical accountability across pathways. Equally, hospitals need sufficient workforce and resources to continue delivering acute and specialist services while this transition takes place.
‘The key challenge is not whether we shift care closer to home, but how we do it. Any transfer of funding or workforce must be accompanied by realistic transition arrangements, investment in community capacity, interoperable digital systems and a clear plan for maintaining safe acute care. Without that, there is a real risk of increasing pressure elsewhere in the system rather than delivering the joined-up, person-centred care that patients need.’
- Read the RCP view on neighbourhood health: planned specialist care
- Read the RCP report, Prescription for outpatients: reimagining planned specialist care
- Read the RCP toolkit, Designing care around people, not buildings