Theresa May today pledged to cut “needless” admissions and help inpatients return home sooner – through community-based rapid response teams and dedicated support for care home residents.
The prime minister announced that there would be investment in primary and community healthcare worth £3.5bn a year in real terms by 2023-24.
“The new approach will mean more people can leave hospital quicker, or avoid being admitted in the first place”
She said it would mean “more NHS patients will be cared for at home”, with the new 24/7 rapid response teams – comprising doctors, nurses and physiotherapists – providing urgent care and support in the community as an alternative to hospital.
This includes emergency treatment as well as support to help patients recover closer to home, which will help people stay healthy and independent for longer.
The creation of the new teams will lead to the “dissolving” of the boundary between GP practices and community nursing, said NHS leaders.
The government said the investment represented a “historic commitment” to ensure a growing share of overall NHS spending went on primary medical and community healthcare.
The announcement forms a key part of the new long-term plan for the NHS, which is due to be published in December.
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Speaking today, Ms May said: “Too often people end up in hospital not because it’s the best place to meet their needs but because the support that would allow them to be treated or recover in their own home just isn’t available.
“That’s why I’m announcing a major boost in funding for community healthcare, which will give more patients a genuine and high-quality alternative to hospital,” said the prime minister.
“For the first time we’re going to guarantee that these services get a growing share of the growing NHS budget”
She said: “The new approach we’re setting out today will mean more people can leave hospital quicker, or avoid being admitted in the first place – which is better for patients and better for the health service.”
The government highlighted that as many as a third of people in hospital stayed longer than they needed to, often because they could not get treatment close to home.
It noted evidence showing that for older people, 10 days in a hospital bed leads to the equivalent of 10 years of muscle ageing – risking their health and reducing their independence.
In addition, it highlighted that analysis suggested that over a third of hospital admissions from care homes are avoidable.
The prime minister has set out a further measure today that is designed to help care home residents get more personalised, convenient and timely care where they live.
She announced the national roll-out of a successful pilot that sees healthcare professionals assigned to care homes.
“The number of district nurses employed by the NHS, the backbone of community health services, has almost halved since 2010”
The idea is the teams, which include pharmacists and GPs who can also offer emergency care out of hours, get to know individual residents’ needs and can provide tailored treatment and support.
Health secretary Matt Hancock said: “Too often our hospitals become the only place to turn for older people, often to the detriment of their health – but no longer.
“The prime minister and I are determined to ensure more people are able to receive care in their communities or at home, taking the pressure of our hard working NHS staff,” he said.
“This additional funding of £3.5bn a year by 2023-24 demonstrates our commitment to primary and community healthcare, capable of relieving the burden on our hospitals over the coming years and revolutionising the way high-quality care is delivered for our most vulnerable patients,” he added.
Simon Stevens, chief executive of NHS England, said: “Everyone can see that to future-proof the NHS we need to radically redesign how primary and community health services work together.
“For community health services, this means quick response to help people who don’t need to be in hospital, as well as dissolving the 70-year-old boundary between GP practices and community nursing,” he said.
“This will make a very significant difference for older and disabled people and their families”
He added: “That’s why – as part of the NHS long-term plan – for the first time we’re going to guarantee that these services get a growing share of the growing NHS budget.”
Dame Donna Kinnair, acting chief executive and general secretary of the Royal College of Nursing, said: “It’s welcome news that the government is focussed on keeping people out of hospital.
“But this announcement begs the question who will operate these bespoke support networks, dedicated healthcare for care residents and rapid response teams,” said Dame Donna.
“The number of district nurses employed by the NHS, the backbone of community health services, has almost halved since 2010, and the number of community nursing staff overall has dropped by 15%,” she said.
“In addition, cuts to training budgets have prevented nurses from joining the community nursing workforce, prompting further staff shortages,” she noted.
She stated that investing in an “expert district nursing workforce and community services must be the priority to keep patients out of hospital”.
“Shifting care from hospitals into primary and community health services has long been a goal of policy”
Julie Ogley, vice president of the Association of Directors of Adult Social Services, said: “We are pleased that the prime minister has announced more funding for primary and community healthcare.
“This will make a very significant difference for older and disabled people and their families,” she said. “We have always maintained that supporting people’s wellbeing at home needs to be the main focus of public services.
She added: “The best way to reduce pressure on hospitals is to provide care which means people don’t end up sick or injured and needing hospital in the first place.”
Anita Charlesworth, director of research and economics at the Health Foundation think-tank, said: “Shifting care from hospitals into primary and community health services has long been a goal of policy.
“But turning that ambition into a reality on the front line has been elusive,” she said. “A renewed focus on this aim is welcome, but change of this magnitude won’t happen simply by moving money.
“This ‘new’ money will be part of the NHS funding settlement already announced, and so will mean hard choices for other areas of the health service that will get less growth,” she noted.
She added: “If primary and community services are genuinely to be the priority, the biggest challenge will be staffing… This financial plan must be backed by a credible transformation and workforce plan.”
Head of policy at NHS Providers, Amber Jabbal, said: “We are pleased to see that community services and primary care are central to the development of the new NHS long term plan and that £3.5bn of the additional £20.5bn will go to these services.
“It is not clear from this announcement whether the additional funding amounts to a significantly increased share of the overall NHS budget for primary and community services,” she said. “We look forward to detailed confirmation that this will be the case.”
However, Nuffield Trust senior policy analyst Sally Gainsbury said: “This additional money amounts to annual increases that are broadly in line with the 3.4% overall that the NHS in England is getting over the next five years.
“That means that, far from representing a big shift in funding towards out-of-hospital services, this money will simply allow GPs and community services to keep up with demand over the next five years,” she added.