Integrated care boards (ICBs) spending less on community care have higher-than-average levels of hospital and emergency activity, new analysis has found.
New data analysis commissioned by NHS Confederation has shown that ICBs spending relatively more on out-of-hospital care saw 15% lower non-elective admission rates and 10% lower ambulance conveyance rates on average, and with lower average activity for elective admissions and A&E attendances.
For every £100 spent in the NHS community care sector, there is a £131 return on investment in acute savings, the figures have shown.
According to the Confederation and Carnall Farrar – who conducted the research – the reduction in acute demand associated with greater community spend could therefore fund itself through savings on acute activity.
An ICS could see an average 31% return on investment and average net saving of £26 million, emphasising the ‘power and potential of community care’ at scale, it said.
Community spend must be prioritised as a mechanism for reducing long-term pressure on the acute sector, the Confederation said, adding that community health services must work with their ICS to properly convey operational performance and impact.
It highlighted that there is no national contract for community services, with spend left to the discretion of local leaders.
Despite this, the Confederation advised NHS England to develop a clearer definition of community care including what services fall under it, and incentivise local leaders to collect data on community services.
And it urged ICBs to:
- Review community spending against need at system level
- Develop a comprehensive inventory of local community care services
- Understand the specific role of local community services and how they work with other settings
- Broaden their understanding of prevention.
Chief executive of the NHS Confederation, Matthew Taylor, said: ‘Successive governments have long held the ambition to shift more care out of hospitals and into the community, but this has never fully materialised. With NHS budgets under huge strain, this analysis shows why it is so important to finally deliver on this long-held ambition. It’s not only better for patients to be treated in or closer to their homes, but it’s also better for the taxpayer.’
