Health and care partners are inviting local people to influence how the NHS in Somerset puts into practice one of the key shifts at the heart of the Government's new 10-Year Health Plan by reshaping the way care is provided in local communities.
Moving care from hospitals to communities is among the three key shifts at the centre of the 10-Year Health Plan, which was published earlier this month, after the biggest national and local conversation about the future of the NHS over the winter. Nationally, 270,000 people took part and among the outcomes was clear support for treating people closer to – and in – their own homes whenever possible, something that people in Somerset have also told the NHS they support.
Now NHS Somerset, which is responsible for planning, paying for and monitoring NHS health services, are asking local people how best to deliver more care closer to home and in their local neighbourhood.
Underpinning the work are six core principles:
- Studies show that people often recover faster in their familiarity of their own home
- Recent data shows that less than one in three community hospital beds is occupied by someone from the local area* and clinicians believe more local people can be supported in their homes, or closer to home, by changing the way we offer care.
- Being in a hospital bed creates risks for patients – it is widely acknowledged** that 'deconditioning syndrome' can lead to reduced muscle strength and circulation, and increased dependence, confusion and demotivation, as well a risk of picking up a hospital-acquired infection (like MRSA)
- Modern ways of providing reablement care allow the same number of NHS staff to look after more people in the community – normally a care home bed, or the patient's own bed – meaning fewer people are stuck in an acute hospital bed when they are medically fit to leave.
- It is nearly seven times more expensive to provide reablement care in a hospital bed compared to reablement care in the patient's own home. People staying in a community hospital bed for reablement care stay on average 37.2days (meaning that bed can only be used by about nine people in a whole year) at an average cost of more than £9,500 per patient. People who get reablement care at home receive it for an average of 17 days at a cost of about £1,400 per person.
- Local and national public engagement schemes – including Somerset's Fit For My Future programme and the 10-Year Health Plan engagement – show clear support for delivering care closer to home.
Today (5 August), NHS Somerset, is formally launching a public engagement programme to help shape the development of its overarching Community Services Strategy.
Community services include:
- Outpatient clinics – where patients receive medical consultations, assessments, treatments, or follow-up care without being admitted to hospital overnight, typically run by consultants, nurses, or other healthcare professionals
- Inpatient care – where patients receive care that requires them to be admitted to a hospital bed
- Therapy services – covering mental and physical health, from talking therapies to physiotherapy and reablement
- Dementia services
- Children's services
Dr Tom MacConnell, a consultant cardiologist and Deputy Chief Medical Officer at NHS Somerset, said: "Since I arrived in Somerset over 30 years ago I have undertaken community outpatient clinics or supported primary care colleagues in online clinical meetings. The publication of the 10-Year Health Plan is a great opportunity to rethink and develop a broader approach to community services.
"We want to retain the essence of community hospitals and to care for people locally, but modernise the way we do this, that's fit for purpose, more than 75 years since the NHS was first created.
"This is about using community resources, including community hospitals, in a way to allow the best possible local delivery of care. This could include local access to chemotherapy, or more x-rays or more outpatient clinics in community settings. We want to get better outcomes with the resources, that are available to our community" Many Somerset residents are clear that when they are ill, they would prefer to be at home, or as close to it as possible, provided the care which gives them the best and safe outcome is available. We're really looking forward to working with local communities to explore what that could look like for them.
"The strategy, which is due to be published later this year, will enshrine the high-level principles of how the local NHS will deliver community services across the county as a whole. Detailed engagement work will also be taking place in neighbourhood areas about how best to deliver the strategy and the 10 Year Health Plan at a local level, in keeping with the 10-Year Health Plan. If you'd like to be part of NHS Somerset's engagement work, email somicb.engagement@nhs.net.
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