NHS Confederation: Hospital-based care 'must change'


Andrew Lansley: "It's not about moving people out of hospitals, it's about giving them the best possible care"

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The NHS in England must end the "hospital-or-bust" attitude to medical care, says the body representing health service trusts.

At least one in four patients would be better off being treated by NHS staff at home, figures suggest.

2012 will be a key year for the NHS as it tries to make £20bn in efficiency savings by 2015, according to the head of the NHS Confederation, Mike Farrar.

Ministers say modernising the NHS will safeguard its future.

Mr Farrar said: "Hospitals play a vital role but we do rely on them for some services which could be provided elsewhere.

"We should be concentrating on reducing hospital stays where this is right for patients, shifting resources into community services, raising standards of general practice, and promoting early intervention and self-care.

Start Quote

The old hospital-based system has to develop into a more preventative, community-based system”

End Quote Steve Field NHS Future Forum

"There is a value-for-money argument for doing this, but it is not just about money and the public need to be told that - this is about building an NHS for the future."

Mr Farrar said the required changes included treating frail people in their homes, and minimising hospital stays wherever possible.

Politicians and NHS leaders must show the public how these changes could improve care, rather than focusing on fears over the closure of hospital services, he added.

"Many of our hospitals know that the patients that they are treating in their beds on any given day could be treated better - with better outcomes for them and their families - if they were treated outside of hospitals in community or primary care," he told BBC Radio 4's Today programme.

'Place of default'

Mr Farrar told Today that people had become used to "the hospital being a place of default" and that primary and community healthcare services had sometimes been under-funded.

Mike Farrar, NHS Confederation: "It's much better for a good number of patients to be cared for in their homes"

But he said even where clinicians knew that better care could be provided outside of hospitals, and politicians accepted this privately, the public debate had not helped individuals understand that.

"We need the politicians and the clinicians to stand together with one voice to explain these changes," he said.

"I think the time has come for real political courage on all parties to stand up and say 'if the evidence is clear that my constituents will get better outcomes because they travel a bit further' or indeed that 'if we can release the costs of these beds to make services available in your own homes' - then that's the right thing to do."

Commenting on the new year message from the NHS Confederation, Health Minister Simon Burns said in a statement: "Modernising the NHS will both safeguard the future of our health service, and will deliver a world-class service that puts patients at the heart of everything it does."

The chair of the independent NHS Future Forum, Steve Field, said: "The old hospital-based system has to develop into a more preventative, community-based system."

And shadow health minister Liz Kendall added there would be "difficult decisions" that had to made.

"The NHS Confederation is right to say this will require real leadership from the NHS and politicians."

But she questioned whether the government would be able to provide this as it was embarking on a major reorganisation of NHS structures.


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  • rate this

    Comment number 611.

    Patients- stop making appointments to demand over-the-counter medications on prescription, stop making your GP come out to your home when you are capable of coming to the surgery, learn how to treat yourself for common viruses and then maybe there will be more money available in the NHS. As a GP, I despair.

  • rate this

    Comment number 605.

    The issue of people taking their relatives in to care for them instead of leaving them in hospitals is for society to decide. I've lived in a country where this would not even be a question however in those societies many females weren't expected to work and they had child care from elderly relatives and basically they as a family for practical purposes just lived near each other.

  • rate this

    Comment number 592.

    In principle could be good, but did we learn nothing from mental health services?Care in the community unable to provide adequate care for complex & severe illness.Decent community care is not cheap and is easy to abuse/neglect the vulnerable.Band-aid treatments and revolving door systems rather than genuine recovery or health (and return to work) are a false economy. If you have no family?Scary.

  • rate this

    Comment number 582.

    I work as a community nurse. Cuts in staffing levels and ever increasing workloads result in stressed and demoralised staff; it is one step forward and two steps back. NHS trusts are being run by accountants, who constantly put pressure on staff to help them achieve savings targets. The humanity has simply gone out of planning, and consequently delivering, services for sick and vulnerable people.

  • rate this

    Comment number 551.

    And this on the back of he NHS to hand over 49% of its capacity to the private sector.
    Do we want strangers in our homes when we are most vulnerable? They will have no back up and no one to supervise them.
    Also, I am sure there are many homes that are just not sanitary enough for someone that has had surgery amongst many other considerations.


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