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Voicepiece – transforming community services

Guides to improving patient care

The transforming community services programme clinical guides will be published this month during Community Services Week, which began on 22 June.

They are the result of months of engagement with as many professionals, patients, organisations and the public as possible to gather consensus on what will really make a difference to the way we provide care for patients in the community.

The six clinical guides encompass services for improving health and well-being and reducing health inequalities; children and families; long-term conditions; acute care in the community; rehabilitation and end of life care. Each of them sets out ambitions for what transformation will achieve, the actions required to realise them and the desired results of the changes that have been made.

The actions are those that have the greatest potential to transform outcomes for patients in each of the clinical areas. All of these actions have either been supported by best available evidence, or by expert, professional experience, confirmed by patients and users.

Most of the high impact changes are not new to services in the community – they are happening in some areas, but crucially, not in all. One of the high impact changes for acute services in the community calls for technical interventions like IV therapy to be widely available, while the for end of life care guide suggests making sure all staff are competent in having difficult conversations, such as breaking bad news.

In general, the guides describe the need to get the basics right every time and for some things to be in place at the outset, including timely provision of equipment, making sure staff have access to appropriate technology and information on what is effective.

Those involved in developing the guides were aware that successful change depends on gaining commitment from front-line staff and harnessing their enthusiasm to deliver improvement. The attributes staff will need for their transformational role build on the practitioner, partner and leader themes from the NHS Next Stage Review, adding innovators, champions of quality and entrepreneurial skills.

Although the attributes are generic across each of the six clinical areas, their application will vary according to the care setting as well as the role and experience of each practitioner. The guides contain prompts about what success will look like and they highlight links to other transforming community services products, notably, the Quality Framework.

While we hope the guides will offer useful insights and ideas, they represent only the first step in the transformational journey. More detailed information will be available on the website and phase two – which addresses strategic issues like workforce planning, modernising education, and career pathways forging strong links across primary, secondary and social care – is already under way.

I would like to take this opportunity to thank the many people who contributed so generously and enthusiastically tothe production of the guides. I am confident their work will motivate and encourage many more to engage with the programme to transform care for patients.