A lack of coordination between primary and community NHS services is leading to ‘sub-standard care’, missed opportunities for community-based treatments and extra strain on hospitals, members of the House of Lords have said.
The Lords called for significant healthcare reform – including for better staff training, data-sharing and flexibility – to ensure value for money.
In a new report, Patients at the centre: integrating primary and community care (15 December), the Lords’ Integration of Primary and Community Care Committee emphasised the need for a seamlessly integrated patient-centric healthcare sector.
It said that integrated care systems (ICSs) are a good starting point for collaborative working but urged the Department of Health and Social Care (DHSC) to evaluate ICS structures before implementing further major health service reforms.
The Lords also urged the DHSC to reform the contract process to encourage multi-disciplinary care and should explore ‘different ownership models for GP practices’ oriented around joined-up care.
And clinicians should be offered job rotations to better understand work in other services, the report added.
Committee chair Baroness Pitkeathley said: ‘For most people the NHS does not mean hospital care but their GP practice [Primary Care] and/or Community Care [district nurses/pharmacists/mental health nurses]. Lack of coordination between these everyday services means patients are receiving sub-standard care and missing out on many services which could help them by ensuring they receive treatment in their own homes or community, without putting extra strain on beleaguered hospitals.
‘An occupational therapist can fix a handle in your bathroom to ensure you don’t fall while a community physiotherapist can keep you active enough to avoid a knee operation. However, a lack of understanding of the importance of such services, poor communication between the service providers and badly coordinated care means wasted NHS resources and frustration for patients.
We need more joined up care, and more focus on preventative services if the NHS is going to be able to address the problems posed by the growing number of people in our society with multiple health issues which need complex and continuous care. It is not an impossible task but requires, as our report sets out, more flexible systems, better data sharing, shared training of staff, good leadership and mutual respect between the many different professions in the system. The reward will be better value for money, a more efficient system and above all, better outcomes for patients.’
