Commenting on the Government's plans to roll out
neighbourhood health teams, Thea Stein, Chief Executive of the
Nuffield Trust said:
“Today's announcement is about expanding and embedding what's
happening already in many places in the NHS. Top quality
community services - like district nursing, end of life care and
rehabilitation - are, in pockets of the country, already working
around the clock to fit care around patients' needs, working
closely with GPs, charities and council staff.
"This approach is essential if we want to end the disjointed ways
of working that too often leave patients to do the time-consuming
and often bewildering job of joining up their own care. So any
attempt to support, develop and spread this approach is welcome,
especially as this work is often underfunded and overlooked.
“But simply saying that the approach will be rolled out, without
full details on how to bring it about, casts doubt on whether it
will stick. This is hard, complex work, requiring leadership from
politicians and NHS staff alike to challenge cultures and power
dynamics, and create new ways to route money through the system
so it doesn't get sucked into the pressing and often urgent needs
of other parts of the health service. It is these dynamics,
rather than a lack of imagination or belief, that has meant that
neighbourhood care has failed to become more than a few passion
projects, like the Derby example cited by ministers.
“What's more, care closer to home doesn't mean care on the cheap.
While ministers are always keen to cite examples of community
services saving money, often this kind of care costs more, not
less, as the economies of scale that might have been realised in
hospital are difficult to achieve in communities. Better
community services is the right aspiration - siloed care is often
frustrating and distressing for patients and contributes to
waste. But let's be under no illusion: this is not a money saving
measure.”
