Shift out of hospitals must be ‘realistic’, warn doctors

A royal college has added to concerns that a shift in NHS funding to expand “neighbourhood” care risks undermining “safe, sustainable hospital services”.

The Royal College of Physicians issued its statement in response to a HSJ interview with Shane DeGaris, chief executive of Barts Health Trust, who warned against “top slicing” acute budgets for neighbourhood schemes when “the work still comes to hospitals”.

The RCP said that while it supports the potential to move services closer to home, “it must be underpinned by adequate investment, workforce capacity and clear plans to maintain safe hospital services during the transition”.

Shifting care out of hospitals without the right infrastructure, specialist input and capacity in community services “risks increasing pressure elsewhere in the NHS, rather than delivering the integrated, patient-centred care that patients need”, it argued.

The Department of Health and Social Care has previously said it is up to integrated care boards to shape service transformation in their area.

RCP’s clinical vice president Hilary Williams said: “The key challenge is not whether we shift care closer to home, but how we do it. Any transfer of funding or workforce must be accompanied by realistic transition arrangements, investment in community capacity, interoperable digital systems and a clear plan for maintaining safe acute care.”