Taking Control Of The Community Services
by Patricia Montgomery, LincsMag Writer.
Date: 01 December 2010
NHS staff across England are taking control of the community services they deliver in a drive to improve outcomes for patients and transform patient care, the Department of Health announced in November.
From April next year, all Primary Care Trusts should have separated the commissioning of community services from their provision.
All staff and services will be transferred to a range of new organisations such as aspirant Community Foundation Trusts and Social Enterprises, or integrate with existing providers. This is part of the Transforming Community Services programme which they hope will deliver more personalised care closer to home.
Community services are meant to provide essential care to many people in vulnerable circumstances, families and communities, from health promotion to end of life care.
The service is an integral part of our local NHS, employing around 200,000 staff and representing around £10bn of NHS spend.
More Choice?
The new organisations will provide more choice for patients and have a vital role in the transfer of care and treatment from hospital settings to help patients with their recovery or manage their healthcare needs. The organisations will support the NHS in its drive to improve quality and productivity, by encouraging clinicians to innovate to transform services, promote healthy lifestyles and focus on prevention.
Implementation of these plans will require real change management expertise, clinical engagement and patient input, to ensure completion of transfers prior to the end of March.
26 per cent of the value of community services currently provided by PCTs will, in the future, be provided by Community Foundation Trusts, and a further 10 per cent by Social Enterprises. Both of these innovative models are aimed to have a strong emphasis on community involvement so that they are accountable to patients and led by local decisions. At least that is the plan.
Community Foundation Trusts should be financially more independent but still part of the NHS family. Eight have already become NHS Trusts and are on their way to gaining Community Foundation Trusts status, with up to another eight to follow.
Community services will also be provided by integrating community services with acute or mental health services. Both of these models have their benefits in providing patients with joined up care or forging strong local authority partnerships.
Minister of State for Health
Simon Burns, Minister of State for Health pointed out, “The proposals we set out in the White Paper aim to put patients at the heart of the NHS, giving them more choice and better control over their care. These changes to community services will enable clinicans to deliver personalised and responsive care and better outcomes for some of the most vulnerable in our society.
“Frontline staff will be in the driving seat to improve quality and integrate services to ensure the most effective outcomes for their patients. And there will be further benefits – frontline staff are best placed to provide the most efficient services so that local NHS money goes further.
“Plans are in place for Social Enterprises to provide almost £900m of services a year a major step towards our ambition to create the largest and most vibrant social enterprise sector in the world.”
Right to Request
The staff led social enterprises will be set up under the Right to Request scheme where over 25,000 NHS staff are expected to transfer to these new local organisations. Three are already up and running – in Hull, Kingston & Leicester.
Ian Dalton, DH Managing Director of Provider Development and Chief Executive of North East SHA, had this to say, "These plans provide firm foundations for transforming these key services and speeding up the transfer of services out of hospitals and in to local communities and people's homes.
“The range of options chosen – including 16 aspirant Community Foundation Trusts and over 60 Right to Request social enterprises – shows the enthusiasm of local NHS staff for taking control of improving services for patients. These are potential 'hot-beds' of innovation and community engagement – but this is only the beginning. The hard work starts now as boards sign off business transactions and plans are completed, and the NHS gets underway with setting up new organisations. They will be able to empower staff to lead change and transform services and working practices."
The NHS currently spends around £10 billion a year on services provided within the community, of which £8.5 billion is currently directly provided by primary care trusts. It is these services that PCTs are working to divest themselves of.
As at 25 November, 98 per cent of these have either already transferred or have been agreed by the Department and are moving towards their final form by April 2011.
