Community services proved essential in pandemic response

Community healthcare services have been critical in preventing hospitals from becoming overwhelmed during the coronavirus pandemic and in allowing people to receive the care they need closer to and within their own homes.

However, without greater investment and support from the Government, their vital contribution is at risk as the NHS braces itself for a challenging winter including the possibility of a second wave of the disease.

The warning comes from the Community Network, which represents community healthcare services across England and is hosted by the NHS Confederation and NHS Providers.

In a report out yesterday (Tuesday 4 August), the network states that despite the longstanding challenges facing community services with significant workforce vacancies and demand outstripping capacity, providers have adapted quickly to COVID-19 and prepared their services to meet people’s needs during the pandemic.

The Community Network calls for investment in home-based community pathways as well as community rehabilitation beds to bolster capacity because the next phase of the pandemic will see significant demand from COVID-19 patients needing long-term rehabilitative care.

A key achievement has been in supporting hospitals to discharge thousands of medically-fit patients safely usually to their own home with appropriate support and care, following the national instruction from NHS England and NHS Improvement (NHSEI) in March, so that beds could be secured for those with coronavirus.

Last month, the Prime Minister announced that £3bn will be given to the NHS to help it cope during what is expected to be a very difficult winter period, of which £500m will portioned off to support the discharge of patients from hospital and into the community.

However, the Community Network believes that longer term support and investment is needed to allow community healthcare services to continue to respond effectively to the greatest challenge the NHS has ever faced, while advancing the national ambition to provide more services closer to where people live.

It is calling on the Government to give the community healthcare services additional funding to manage these competing demands and also, to invest more in public health and social care, which have similarly experienced funding cuts that can impact on the sector.

Additionally, the network is urging the Department of Health and Social Care to help boost the community workforce with a national recruitment campaign and deploying more returners to their services before winter pressures hit.

Andrew Ridley, chair of the Community Network, which is run by the NHS Confederation and NHS Providers, as well as chief executive of Central London Community Healthcare NHS Trust said:

“Over the past few months, community healthcare services have shown their value, flexibility and resilience by playing a critical role in preventing the NHS from becoming overwhelmed in the face of the greatest crisis of modern times. This has been particularly remarkable given that community health services entered the pandemic under considerable pressure due to rising demand, workforce shortages and increasingly complex patient needs.

“The cash injection announced recently by the Government to support community healthcare services over winter was welcome but it is a sticking plaster for the longer term support and investment that this sector desperately needs.

“Without additional funding, including for social care and public health, and the workforce to deliver its services, there is the real risk that discharge arrangements will be compromised and hospitals could become overwhelmed. We need realism about what these services will be able to deliver safely in the next stage of the pandemic.

“More broadly, the experiences of the pandemic must be used as a catalyst for change to reset how services are delivered and to reinvigorate the national ambition to provide more care closer to people’s own homes.”

Community services play a key role in keeping people well and in treating and managing a range of illnesses and long-term conditions away from hospital settings and closer to where people live, including in their own homes. Their services are wide ranging and can include health visiting, district nursing, physiotherapy, smoking cessation and out of hours care, and they are commissioned by the NHS or by local authorities.

Elsewhere in its report on the ‘Impact of Covid-19 on NHS community services’, the Community Network is calling for:

• The Government to pause the time-consuming retendering of local authority contracts during the COVID-19 emergency so that providers can have more stability and focus on delivering care. This repeated plea follows the Community Network first writing to the Secretaries of State for Health and Social Care and for Housing, Communities and Local Government about this earlier this year.
• The Department of Health and Social Care (DHSC) to commit to fund in full the Agenda for Change pay uplift for staff employed on NHS contracts through health services that are commissioned by local authorities.
• For the DHSC and NHSEI to invest in home-based community pathways as well as community rehabilitation beds to ‘bolster’ capacity. This is essential as community health services will play a key role in supporting patients who have been seriously ill with COVID-19 for some time to come, at the same time as maintaining surge capacity and phasing back in essential services.