Hospitals urged to look to communities to deliver health improvement

19 Mar 15

Hospitals must avoid developing a ‘fortress mentality’ in response to mounting service and financial pressures and look outwards to their local communities to improve the health of the people they serve, a Kings Fund report has said.

The think-tank argued that acute hospitals will need to play a fundamentally different role within local health economies if the vision described in the NHS Five Year Forward View is to be achieved.

The Forward View, published last October, sets out how services would have to change to deliver new models of care to meet the needs of the future.

The King’s Fund called on hospital leaders to work more closely with primary care, social care and community services.

Its Acute hospitals and integrated care report said this would need to include a bigger role for them in prevention and public health and greater collaboration with neighbouring hospitals to improve services for patients.

To ensure that these ways of working become widespread and support the vision set out in the Forward View, the fund said significant changes were also needed in how health services were paid for, regulated and commissioned.

The report also recommended that hospitals develop a new regulatory model with greater emphasis on whole-system performance, continue to develop a range of alternative payment systems, supporting local commissioners to move away from activity-based tariffs for hospital care. It should also introduce a transformation fund that ensures that all areas of the country are able to cover the costs of the transition to more integrated models of care.

A full list of suggestions from the fund can be viewed here

Chris Naylor, senior fellow at the King’s Fund, said: ‘We are seeing an important shift in thinking in some acute trusts. Hospital leaders are telling us that they see their role increasingly in terms of system leadership, and that working closely with local partners is key to the survival of the services they provide.

‘However, the picture varies across the country, and even in those areas where most progress has been made, there is still a long way to go before the new models of care described in the Forward View can become a reality. One critical area where rapid progress is needed is improving the relationship between hospitals and primary care – this has all too often held back successful integrated care.’

Responding to the King’s Fund report, NHS Confederation director of policy Johnny Marshall said it reinforced ‘what we have been saying for some time’.

‘[That is] all NHS bodies, including acute trusts, need to look beyond the boundaries of their own organisation, and work with key partners, including local government, to improve the health and wellbeing of their local communities,’ he said.

‘There are many examples of this kind of leadership across the health service but we need government to support this approach – stability is key to building these local partnerships. The next government must avoid another top-down reorganisation of NHS structures at all costs.’

  • Judith Ugwumadu

    Judith Ugwumadu joined Public Finance International and Public Finance online as a reporter after stints at Financial Adviser, Global Security Finance and The Sunday Express. Currently, she writes about public finance, public services and economics.

    Follow her on @JudithUgwumadu_

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