The NHS’ 5 year Forward Plan published in 2014 and the Better Care Fund provides the context for exploring more effective and more patient-centred approaches to keeping populations healthy and caring outside of hospital wherever possible. This usually implies building capacity in the community both to prevent hospital admission and to offer an early opportunity for discharge following an acute episode.
Developing new models of care in which the traditional divide between primary care, community care and hospitals is challenged is key to the Forward View. It is no longer adequate or helpful to distinguish and separate services if the goal is to respond to patient need holistically and with a focus on outcomes. The 5 Year Forward View emphasises personalised and coordinated care recognising that health care cannot achieve this without integration with social care.
The solutions we have investigated on behalf of clients include improvement to processes e.g. patient admission and discharge; developing and implementing models for ‘Discharge to Assess’ and health and social care hubs or MCPs. We have also been involved in the procurement and transfer of community-based services and evaluating the balance between community and bed-based care.
