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APR 24/2014

Moving NHS care out of hospitals: a fundamental shift

The NHS is constantly undergoing various evolutions and operational changes to ensure patients can receive the best possible quality of care. However, there is little argument that current efforts to reform the health service signify some of the most dramatic changes since its inception.

Of the many measures the Department of Health has enacted recently to alter the overall direction of the NHS, there are few that represent as much of a fundamental shift as the increased prioritisation of care provided outside of the hospital setting.

By assessing the ways in which this change is manifesting itself and the reasons why it is happening, healthcare professionals can come to understand how it will affect them - as well as how it could lead to the creation of more home care jobs and stimulate recruitment in other sectors.

What measures are being taken?
Efforts to provide better out-of-hospital care has been an NHS focus for some years now, but efforts to do so are starting to gather momentum. The government has taken steps to introduce a more integrated and holistic approach to service planning through the introduction of new management structures such as clinical commissioning groups, with the aim of ensuring services are supplied by a wider range of providers.

Under the details of the new GP contract, general practitioners will be tasked with overseeing individual patients' journey through different departments, coordinating with other professionals to make sure patients can see all sorts of different specialists without their case details being lost in the shuffle.

Meanwhile, the rollout of personal health budgets will give patients more choice to select the care providers they feel they will benefit from the most, rather than having their treatment pathway dictated to them. This will enable those who would prefer a community-based care approach to receive one.

Additionally, telehealth services are making it easier than ever for patients to receive consultations via Skype or email without needing to visit their doctor's office.

Why is this happening?
It is increasingly understood that many patients prefer to receive treatment at home or in a community setting, rather than having to visit hospital either for an outpatient appointment or a longer stay. Such an approach can enhance their quality of life and deliver better outcomes.

Moreover, an enhanced community care infrastructure can relieve some of the pressure on the acute hospital sector, reducing the number of people attending oversubscribed accident and emergency departments. This can be achieved not only by offering alternative sources of help, but also by encouraging people to conveniently have their problems seen to before a medical emergency occurs, rather than afterwards.

Which sectors stand to benefit?
Naturally, such a shift is likely to create more jobs in the home care sector, as more patients with long-term conditions choose to receive medical attention in the comfort of their own domiciles, rather than on a ward.

The oft-underutilised physiotherapy field will also stand to benefit, as people will be empowered and encouraged to choose this form of treatment to aid their long-term recovery as part of an expanded selection of services. Meanwhile, community pharmacists will be able to play a greater role in the overall care landscape, becoming seen as the first point of contact for health issues by many who would currently make a GP or hospital appointment instead.

Finally, it is expected that those working in traditional acute care roles will see their overall workloads reduce as a result of this shift, ensuring they are able to dedicate more of their time to genuine medical emergencies.

As such, the transition towards out-of-hospital care could not only be one of the most significant changes in NHS history, but also one of the most beneficial.

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