21.05.18
Community services still ‘overstretched and underfunded’, despite promises
Promises to bring more patient care closer to home have fallen flat, according to a report by NHS Providers.
Multiple national strategies have concluded that the NHS must do more to help people stay well in their own homes and communities, avoiding the need for hospital treatment; most recently the Five Year Forward View (FYFV).
The FYFV envisaged a significantly expanded role for community services, such as community specialist nurses and physiotherapy.
However, the report concludes that support on the ground has failed to match the rhetoric, leaving providers marginalised, underfunded and short staffed.
The report, ‘NHS community services, taking centre stage’, highlights findings from a survey of leaders of 71 NHS trusts, including more than half of those providing community services.
Over half of community trusts said that funding in their area had fallen in this financial year, and 44% said that they were cutting costs, with almost a third reported having cut staff.
Almost two-thirds said that they were worried or very worried about community services’ ability to maintain adequate staffing in 12 months’ time.
A massive 82% of all provider trusts were either worried or very worried that community health services would not receive the investment they need to deliver the ambitions of the FYFV.
Over 90% of leaders said that, based on current trends, the gap between funding and demand for community services will grow over the next 12 months; the same proportion was also concerned that community services receive less national level priority than other sectors.
The report concludes that the expansion of community services has not materialised because they are not sufficiently understood or prioritised at a national or local level, are overstretched, underfunded and understaffed, and held back by “burdensome competition and procurement rules.”
Chris Hopson, chief executive of NHS Providers, said that NHS community services are in a unique position to act as integrators, working across boundaries and collaborating with other parts of the public sector in order to tackle health inequalities.
“And yet – as our survey makes clear – all too often NHS community services are marginalised, underfunded and short staffed,” he added.
“It is patients who are paying the price for the failure to follow through on past commitments as the rest of the health and care system struggles to keep up with rising demand for treatment.”
He called for a greater priority to be given to community services at a national level, as well as within sustainability and transformation partnerships and integrated care systems, with adequate funding and action to address staff shortages.
“It is vital that national leaders address the barriers we have identified to ensure that community services are at the heart of the future health and care system,” Hopson concluded.
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