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CCG Series: The importance of community hospitals

CCG Series: The importance of community hospitals


Chief clinical officer of South Worcestershire clinical commissioning group (CCG), Dr Ellson believes that commissioners should be working more closely with community hospitals

We’re all aware that demand for health care services is changing with the emphasis and so-called left shift towards locality-based health services. There is also more focus on integration and coordinated care as a means to reduce fragmentation within the health and social care systems and deliver good patient outcomes. 

The current pressures of demographic change and the difficult financial climate mean that we need to explore and expand the range of options that may be provided in a community setting. 

I believe that community hospitals sit at the heart of this. 

Community hospitals will need to play a key role in integrating care, but for this to happen, changes to the way services are currently commissioned is needed. Commissioners and providers need to work more closely to develop a joint vision, providing a new direction and fresh focus for these valuable resources. Currently a common feature across the community hospital estate is variability. We need to balance a more consistent offering which on the one hand supports the broader challenges faced by the CCGs and their partners but also meets the needs of the local population. 

In South Worcestershire, community hospitals have been an integral part of the landscape going back many years. However, for far too long they have been under-utilised. With financial constraints, pressures in our acute services and an ageing population that are predominately based in a rural setting, we’re aware that significant change and redirection of funding is needed to make best use of these critical resources. 

In our urgent care strategy we’ve outlined our commitment to enhancing the role of these resources. We’ve developed a joint vision with partner organisations and taken significant steps on the road to transforming these facilities to deliver a more integrated model of care. 

A recurrent investment to facilitate a move to a new model of care which includes daily ward rounds and regular patient reviews that support prompt and timely patient discharge has been made. Medical cover is being revised and an important element of the specification for this service is maintaining the important links between the delivery of the medical cover and local GPs and practices. This is included within our specification, reflecting important feedback from local communities who really valued this link.

The aim is that in the near future these hospitals become ‘centres’ for wider community teams by enabling acute hospitals to focus on patients who require specialist secondary care and ease the pressure on their beds, clinics and emergency services.  

Perhaps the next steps for community hospitals are that they provide same day access to urgent primary care which would complement the out of hours service and by doing so provide enhanced support to the minor injury units that are based in our community hospitals.  We should make more effective use of inpatient and ambulatory services offered locally, including rehabilitation, reablement and specialist dementia and palliative care services. 

Clearly this needs thinking through, and I am sure there are other options that I have not thought of.  But what I do think is important is that these hospitals make a real contribution to the health and wellbeing of local people, particularly in the challenging times in which we are now operating. 


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