UK government reveals neighbourhood healthcare delivery plan
UK Prime Minister Sir Keir Starmer is due to reveal the long-awaited 10 Year Plan for the NHS later today, but revealed some more of the detail of one of the pillars of the policy – shifting care into the community.
The crux of the plan is to launch 'Neighbourhood Health Services' across the country – delivering diagnostics, mental health services, post-operative care, rehabilitation, and nursing – through a network of community health centres.
It is the first stage in a long-term plan to deliver most outpatient care outside of hospitals by 2035, said Starmer, who said the move will "fundamentally rewire and future-proof" the NHS and put care "at people's doorsteps."
The PM pledged to deliver "access to GPs, nurses, and wider support all under one roof in their neighbourhood" as part of a suite of measures that aim to reverse what the Darzi report last year said was years of decline that had left the NHS in critical condition.
Along with the neighbourhood care drive, the 10 Year Plan will focus on digitising care and moving from treatment towards prevention of ill health as the government tries to bring down waiting lists that remain stubbornly high since the pandemic.
The new health centres – around 200 will be set up in the next decade, according to plan – will eventually be open 12 hours a day, six days a week within local communities and, along with healthcare, will also provide other social care services like debt advice and employment support. They will be staffed by nurses, doctors, social care workers, pharmacists, health visitors, palliative care staff, and paramedics.
Responding to the report, health think tank Nuffield Trust said the neighbourhood approach "is essential if we want to end the disjointed ways of working that too often leave patients to do the time-consuming and often bewildering job of joining up their own care."
Chief executive Thea Stein cautioned, however, that without the details of how it will be delivered it raises "doubt on whether it will stick," saying: "This is hard, complex work, requiring leadership from politicians and NHS staff alike to challenge cultures and power dynamics, and create new ways to route money through the system so it doesn't get sucked into the pressing and often urgent needs of other parts of the health service."
Stain also said that this sort of care does not come cheap, asserting: "Let's be under no illusion: this is not a money saving measure. While ministers are always keen to cite examples of community services saving money, often this kind of care costs more, not less, as the economies of scale that might have been realised in hospital are difficult to achieve in communities."
The government has said the money to pay for the new service will come from the £29 billion boost to NHS funding announced in the last Budget. Meanwhile, however, it is facing a black hole in its financial planning, with a recent backtrack on welfare cuts.
Another think tank, The King's Fund, said the key questions to be answered when the 10 Year Plan is finally unveiled will be, why will the community care drive be different from earlier attempts, how soon will it lead to improvements, and how can it be achieved – unlike previous plans – without significant funding increases?
"History has shown us that you can't simply co-locate different health professionals in a building and expect a neighbourhood health service to flourish. In order to ultimately offer a more personalised service to the public, health and social care professionals will need to work differently to join up patient care," commented CEO Sarah Woolnough.
"This does not feel sufficiently radical to provide the sea change that's required."
