Comment / The value of community services

Throughout the pandemic so far, NHS community services have supported people to stay well and stay at home or be cared for in the community. Through doing this, they have been a vital part of the system response by keeping people away from acute settings.

Enabling people to stay at home and manage their condition, is an important role of community services. An HFMA report last year, The value of community services: helping people stay healthy, happy and independent, considered the many and varied ways that the sector encourages people to lead healthy lifestyles and prevent ill health. As the NHS considers how to increase capacity once more, the prevention agenda becomes ever more important.

Many community services organisations have reported improved relationships with local partners in the acute sector and social care during the pandemic, with noticeable changes to the efficiency of system working and governance processes. Staff flexibility has also been welcomed, with workforce transferring between settings to support the needs of patients.

Community services have always played a role in developing system working, as one of the sectors that interacts with nearly all system partners to deliver patient care. Our report, The value of community services: enabling system working, looked at how services work across organisational boundaries, not just within the NHS but also social care and the wider public sector, recognising the impact that housing and employment can have on health and wellbeing.

There is much to celebrate in the response of NHS community services, and their wider systems, to Covid-19. Several of our members who work in the sector have shared their experiences in the HFMAtalk podcast series.

However, there have also been implications for NHS community services, as Covid-19 had for all parts of the health and care system. Many aspects of traditionally acute care can be delivered in the community. The HFMA report The value of community services: comparison with acute settings looked at examples of services being delivered in community settings, care homes and people’s own homes. However, the acuity of patients in the community has increased, placing additional demands on staff.  Some community services had to be stopped or much reduced to redeploy staff to care for those discharged from hospital. As the pandemic progressed, this support extended to those recovering from Covid-19 in the community. In addition, the way that services were delivered had to change. As for much of the NHS, there was a rapid uptake of digital methods in community services with virtual and telephone consultations replacing face-to-face contact.

Now, as the pandemic eases, services need to be restored at the same time as maintaining, and increasing, the additional services put in place to address the demands of Covid-19. While many of these begin to address the ambitions for community services in the NHS long term plan, funding them is difficult, with many NHS community providers having to make difficult choices about what can be sustained. As the NHS considers what the future will look like, it is vital that the role of community services is not forgotten.