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News Article
Norfolk and Norwich Hospital unable to discharge 180 patients
Patient Safety Learning posted a news article in News
A senior hospital nurse said she could not discharge 180 patients due to a lack of "care and support" at home. Norfolk and Norwich University Hospital said among the people that did not need to be in hospital was a patient who had been there for 145 days. Claire Fare, senior discharge matron, said delays "impact on the whole of the flow" of patients. Norfolk County Council's social care department blamed the "national care crisis" for the problems. In June, the hospital, which has about 1,200 beds, pleaded for family and friends to help look after fit patients to ease demand. Melanie Syson, the hospital's discharge coordinator, said there was a person in the hospital ready for discharge that had been there for more than four months. "She is medically fit to be discharged but we are waiting for support to be ready at home," she said. Ms Syson added: "The length of stay of the patients seems to be getting longer." To help cope with the delays, the hospital opened a "home-first unit" in January for patients who did not need acute care but it was unable to discharge. The unit focuses on rehabilitation to try to prevent the patients coming back into hospital or requiring more care at home. Stephanie Ward, the ward sister, said it aimed to "give patients the time they need to do things themselves as much as they can". Read full story Source: BBC News, 15 July 2022 -
News Article
Rehab services ‘very bizarre’ in some places, says NHSE director
Patient Safety Learning posted a news article in News
NHS England’s director of community health has said a new strategy for rehabilitation care is needed, because present coverage is sometimes ‘bizarre’, with other services ‘masquerading’ as rehab. Matthew Winn, who is also Cambridgeshire Community Services Trust CEO and senior responsible officer of the “ageing well” programme in the NHS long-term plan, made the comments in a webinar for local senior clinicians and managers in the sector. He said there was an intention to roll out a national “intermediate care strategy”, describing it as “the essence” of providing rehabilitation and helping hospital patients to “optimise, to recover, to rehab through a skilled multiprofessional team”. They would leave hospital in a “timely pathway” and not need as much social care support afterwards. It comes amid huge pressure to speed up hospital discharge, which often relies on rehab services. Read full story (paywalled) Source: HSJ, 14 July 2022 -
News Article
Government to pick ‘integration frontrunners’ to test ‘radical new approaches’
Patient Safety Learning posted a news article in News
Government will pick five or six ‘integration frontrunner’ areas ‘to lead the way in developing and testing radical new approaches’ to speeding up discharge from acute hospitals. Along with NHS England, ministers today wrote to local NHS and council directors asking for bids to take part by 30 June. They said there was “a need to take a more fundamental look at [how the] system currently manages the discharge of patients, their post-acute care, and their access to high-quality social care”. The “discharge integration frontrunner sites” will focus on exploring “new service models, such as the delivery of a more integrated model for intermediate care across existing health and social care”, and “designing and testing new enabling arrangements, which might include new funding models, more integrated workforce models, or the deployment of new technologies”, their letter said. They said speeding up hospital discharge was “just one” potential benefit from integration and indicated that “future phases” of frontrunners may focus elsewhere. But delayed discharge has been a major pressure on the system over the past year, particularly last winter, and the letter says: “Delayed discharges are one very visible signal that the health and care system remains fragmented and too often fails to deliver joined-up services that meet people’s needs.” Read full story (paywalled) Source: HSJ, 21 June 2022 -
News ArticlePharmacists say physical and verbal abuse against them has become unacceptably common and many now feel unsafe when at work. Police forces say they are being called out to handle pharmacy-based crimes. The Pharmacists' Defence Association (PDA) says there have been reports of a stabbing and physical attacks in pharmacies around the UK and that more needs to be done to enforce the NHS's zero tolerance policy on worker abuse.. Pharmacist Conor McAreavey was stabbed in the hand with a knife at his pharmacy in Belfast in March. He told the BBC he was "very lucky" not to have suffered tendon damage. Glasgow pharmacist Chand Kausar was threatened with a knife by an agitated patient, who - after demanding non-prescribed medication - produced a six-inch knife and cornered her against a wall. "I just froze," explains Ms Kausar. "My hands were above my head and I could hear all the noise around me, but I actually felt very calm. In my head all was quiet. I remember thinking it was like a movie scene. I'd never seen a knife like that, and I never imagined I'd have one held to my throat." The PDA launched an online survey in April 2022 and nearly 550 community pharmacists, mostly staff working in England, have responded so far. Some 468 of them - 85% - say they, or someone they work with, experienced verbal or racial abuse in the previous month while at work. One respondent said: "I feel terrified going to work every single day, and yet management are ignoring the issue." Read full story Source: BBC News, 6 June 2022
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News Article
Pharmacy leaders hit out at NHS England ads redirecting patients from GPs
Patient Safety Learning posted a news article in News
Pharmacies do not have the capacity to absorb pressure from GPs unless it comes with additional funding, pharmacy leaders have warned. A new NHS England ad campaign, announced earlier this week, aims to redirect patients from GP practices to local pharmacies for minor conditions such as coughs, aches, cystitis and colds. But community pharmacy negotiating body PSNC has spoken out against the campaign calling it ‘deeply concerning’, ‘irresponsible, ‘extremely unhelpful’ and ‘irritating’. Malcom Harrison, chief executive of the Company Chemists’ Association (CCA) said: ‘Community pharmacies are often the best place for patient to go for help with minor health concerns. ‘However the current situation that many pharmacies find themselves, with a 30% cut in real term funding, the NHS recruiting their pharmacists and technicians to work in general practice and with the continuing increase in the number of medicines prescribed, will mean that there is now a very real risk that when patients visit a pharmacy, they will be faced by exhausted teams and longer than expected waiting times. ‘The NHS policy of moving asking patients to visit their local pharmacy does not address the problem of delays to access in primary care, it simply moves it from one pressurized location to another. The NHS must address the chronic underfunding of primary care, and of pharmacy in particular, if patients are to be able to access the care they need and should rightly expect.’ Read full story Source: Pulse, 28 February 2023 -
News Article
‘NHS factors’ lead to more than a third of delayed discharges
Patient Safety Learning posted a news article in News
More than a third of delayed discharges for long-stay patients are being caused by factors generally associated with the NHS, according to new data obtained by HSJ. Delayed discharges from hospital are often blamed on issues around social care, but figures for the nine months to January, for patients who have been in hospital for at least 21 days, suggest a significant proportion are due to NHS-related delays. The most common reason is waiting for rehabilitation beds in a community hospital or similar facility, which accounts for 23% of total delayed discharges, based on daily averages. Other reasons generally associated with NHS-related issues included delays around medical decisions (4%), therapist decisions (4 per cent), transfers to another acute site (2%), and diagnostic tests (1%). On top of this, a further 12% of the causes were at least partly associated with the NHS, such as delays relating to transfer of care hubs, which are generally jointly run with councils. Read full story (paywalled) Source: HSJ, 9 February 2023 -
News ArticleCommunity health workers are stepping in to provide critical services and information in rural areas in Texas, USA, with few hospitals or doctors. When Claudia Salazar and her family migrated to San Elizario, Texas, a small city in El Paso county, they settled into a colonia – informal, low-income housing often found in rural parts along the US-Mexico border. But the remoteness of their new home soon presented problems – Salazar suddenly found herself in a medical desert. The nearest hospital is a 35-minute drive away. Even that is challenging to get to – the community’s mostly farm worker population works 10- to 12-hour days, and often lacks adequate time to travel for medical attention between workdays. The lack of consistent medical access is just one of the many public health issues that colonias face, and a group of women familiar with the dynamics in this region thought of a relatively simple solution: bringing medical care to the people who need it most in these borderland communities. “Familias Triunfadoras has been really helpful since they provide a mobile unit clinic,” Salazar said. “That’s when we get a chance to visit a doctor or get a doctor’s appointment.” Familias Triunfadoras is a San Elizario-based non-profit that is composed of women who step in as community organizers to connect residents like Salazar to resources they may not know exist. Their efforts to make healthcare more accessible in medical deserts like San Elizario has proven invaluable to residents. Read full story Source: The Guardian, 2 February 2023
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News Article
Care providers ask for doubled fees to care for people discharged from hospitals
Patient Safety Learning posted a news article in News
Care providers are demanding double the usual fees to look after thousands of people who need to be discharged from hospitals to ease the crisis in the NHS. Care England, which represents the largest private care home providers, said on Sunday it wanted the government to pay them £1,500 a week per person, citing the need to pay care workers more and hire rehabilitation specialists so people languishing in hospital can eventually be sent home. The rate is about double what most local authorities currently pay for care home beds, an amount Martin Green, the chief executive of Care England, described as “inadequate”. The demand comes as the health secretary, Steve Barclay promised “urgent action” with up to £250m in new funding for the NHS to buy care beds to clear wards of medically fit patients. The money will be used to buy beds in care homes, hospices and hotels where people are looked after by homecare providers, as well as pay for hospital upgrades. Stays will be no longer than four weeks until the end of March. The use of hotels as care homes began during the pandemic and has been controversial, with reports of problems with hygiene and supplies of specialist equipment. The charity Age UK last week criticised their renewed use as “not an appropriate place to provide high-quality care for older people in need of support to recuperate after a spell in hospital”. Read full story Source: The Guardian, 9 January 2023 -
News Article
Patients ‘warehoused’ and ‘lost in the system’ amid rush to discharge
Patient Safety Learning posted a news article in News
More and more older people are being “warehoused” in inappropriate care beds, condemned unnecessarily to long-term care, and “lost” to health and care services, due to the rush to discharge from full hospitals and a lack of community rehab services, leaders have warned. Several senior figures in community and social care have raised the issue with HSJ, warning it has been a growing concern over the past 18 months of severe system pressure following on from acute covid peaks. The Health and Safety Investigation Branch has also raised the issue, telling HSJ inappropriate care placements are leading to harm and readmissions, while a major accountability gap remained over the safety of discharges. The average length of hospital stay has increased compared to pre-Covid, with a big jump in those staying more than three weeks. Many in the NHS put this down to a lack of social care capacity meaning more medically fit people are stuck in hospital. Senior staff in community health and social care services told HSJ hospitals were increasingly demanding rapid discharges, often as part of “surge” measures when they are very full and under pressure to reduce ambulance queues. Homecare cannot be organised, and with suitable step-down and care beds also full, trusts are instead “spot purchasing” space in unsuitable homes which may be a long journey from the person’s home area, and in a different council area. Read full story (paywalled) Source: HSJ, 5 January 2023 Further reading HSIB interim bulletin - Harm caused by delays in transferring patients to the right place of care -
News Article
Council providing three-minute care visits to vulnerable, finds ombudsman
Patient Safety Learning posted a news article in News
Care workers are taking as little as three minutes to help vulnerable people in their own homes, the social care ombudsman has found, after discovering a council was allocating extremely short visits to hundreds of people. Amid chronic staff shortages and rising unmet care needs nationwide, a homecare worker commissioned by Warrington borough council sometimes stayed for just three minutes, despite the family paying for the full visit. The council was found to have allocated 15-minute care calls to more than 300 people in the region, despite national guidance stressing these were “not usually appropriate”. The Homecare Association, which represents care providers, said the number of short calls being commissioned was increasing more widely and said “15-minute visits are inappropriately short”, result in inadequate care and are stressful for workers placed under “unfair pressure”. The case that triggered the investigation involved a woman with dementia who was paying the full costs of her care under a plan devised by the council. In 15 minutes two agency care workers were expected to wake her, prepare a meal and a drink, ensure she ate and drank, administer her medication, change her incontinence pad, administer any personal care and tidy the kitchen. Electronic monitoring showed they regularly stayed less than 15 minutes and the ombudsman said it was probable her care needs were not met and her care was not dignified. Read full story Source: The Guardian, 5 January 2023 -
News ArticleTechnology that accurately predicts when patients will be ready to leave hospital upon their arrival in A&E is being introduced to solve the NHS bed-blocking crisis. The artificial intelligence (AI) software analyses data including age, medical conditions and previous hospital stays to estimate how long a patient will need to remain. Hospital managers can then alert social care services in advance about the date when patients are expected to be discharged, allowing care home beds or community care packages to be prepared. Nurses said the technology had “revolutionised” their ability to discharge patients on time, meaning people who would otherwise have been stuck in hospital had got home for Christmas. The new technology, developed by the British AI company Faculty, is being tested at four NHS hospitals in Wales belonging to the Hywel Dda health board. Analysis suggests that the tool will save NHS trusts 3,000 bed days and £1.4 million a year by speeding up discharges, which in turn frees beds for elective procedures such as hip replacements. Read full story (paywalled) Source: The Times, 26 December 2022
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News ArticleFamilies of people with dementia have said there is a national crisis in care safety as it emerged that more than half of residential homes reported on by inspectors this year were rated “inadequate” or requiring improvement – up from less than a third pre-pandemic. Serious and often shocking failings uncovered in previously “good” homes in recent months include people left in bed “for months”, pain medicine not being administered, violence between residents and malnutrition – including one person who didn’t eat for a month. In homes in England where standards have slumped from “good” to “inadequate”, residents’ dressings went unchanged for 20 days, there were “revolting” filthy carpets, “unexplained and unwitnessed wounds” and equipment was ”encrusted with dirt”, inspectors’ reports showed. Nearly one in 10 care homes in England that offer dementia support reported on by Care Quality Commission inspectors in 2022 were given the very worst rating – more than three times the ratio in 2019, according to Guardian analysis. Read full story Source: 29 December 2022
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News ArticleHundreds of thousands of children have been left waiting by the NHS for the developmental therapies they need, with some waiting more than two years, The Independent can reveal. The long waiting lists for services such as speech and language therapy will see a generation of children held back in their development and will “impact Britain for the long haul”, according to the head of the Royal College of Paediatrics and Child Health (RCPCH). More than 1,500 children have been left waiting for two years for NHS therapies, according to internal data obtained by The Independent, while a further 9,000 have been waiting for more than a year. The total waiting list for children’s care in the community is 209,000. Dr Camilla Kingdon, president of the RCPCH, told The Independent: “The extent of the community waiting lists is extremely alarming. Community health services such as autism services, mental health support and speech and language therapy play a vital role in a child’s development into healthy adulthood, and in helping children from all backgrounds reach their full potential. “A lack of access to community health services also has direct implications for children and families in socio-economic terms. Delays accessing these essential services can impact social development, school readiness and educational outcomes, and further drive health inequalities across the country.” She said health and care staff are working immensely hard, but that without support they will struggle to address the long delays, which will “impact Britain for the long haul”. Read full story Source: The Independent, 26 December 2022
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News Article
Pharmacies say they’ll collapse without funding
Patient Safety Learning posted a news article in News
England’s network of community pharmacies is “close to collapse”, with serious consequences for millions of patients, industry leaders have warned. In a letter sent to Steve Barclay, the health secretary, they cautioned that “as a sector we are now at a fork in the road”, and urged him to “make a critical choice about the role you want pharmacies to play”. The government has said it wants to make more use of community pharmacies in England to ease pressures on GP surgeries and accident and emergency departments. But the letter argues that funding cuts over the past seven years makes this goal unrealistic. It warns: “Many pharmacies are now dispensing at a loss and facing a serious cashflow crisis which we fear if not addressed, will rapidly move towards many permanent closures. We fear that once they start, closures will be hard to stop, as the sector is now so fragile other pharmacies would struggle to pick up the slack. “We are deeply concerned that this will put medicine supply at risk — with serious consequences for the millions of people who rely on dispensed prescriptions every year.” Read full story (paywalled) Source: The Times, 23 December 2022 -
News ArticleThe current GP funding model ‘does not sit comfortably’ with NHS England’s plans for primary and community care integration, according to a senior NHS England director. In a Lords Committee hearing today, NHS England’s national director of primary and community care services Dr Amanda Doyle said a ‘rethink’ was required with regards to the primary care estate, with Integrated Care Boards (ICBs) tasked to draw up local plans. Asked whether the GP partnership model was compatible with integration, Dr Doyle told the committee that this was ‘one of the challenges’ they are facing. She said: "One of the challenges that the current predominant ownership model in general practice gives us is that both investment and revenue flows support that model [of] an individual, practice-sized building. "And lots of the things we want to do as we move forward into co-located primary care services and scaled-up primary care delivery drive the need for bigger premises with a wider range of capacity, and those two models don’t sit comfortably together." Read full story Source: Pulse, 19 June 2023
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News Article
Ministers seek volunteer social care army to speed up hospital discharges
Patient Safety Learning posted a news article in News
Health ministers are to recruit a new volunteer army for social care to ferry medical equipment and drugs to people’s homes in a bid to free up congested hospital wards. Under the plan, members of the public will be able to sign up on the GoodSam app for roles such as “check in and chat”, which involves support over the phone for people struggling with loneliness. There will also be the chance to “pick up and deliver”, helping to transport medicines or small items of medical equipment to people’s homes from NHS sites so they can be discharged from hospital, and “community response” roles will involve collecting and delivering shopping and prescriptions. The joint NHS and social care volunteers responders programme for England is being launched on Wednesday amid a social care staffing crisis with 165,000 vacancies and millions of hours of care needs not being met. At the end of April, 49,000 people every day had to stay in NHS hospitals in England despite no longer meeting the criteria to be there. News of the planned announcement from the care minister, Helen Whately, has sparked concern among workers in the sector, who warned that volunteering could not solve the social care recruitment and retention crisis. Helen Wildbore, director of Care Rights UK, which represents relatives and residents, said it “feels like a desperate measure to try and save a system that is crumbling”. Read full story Source: The Guardian, 6 June 2023 -
News ArticlePlans to procure more district nursing courses to start this September have been paused because of the merger of Health Education England into NHS England, HSJ understands. An email sent last month from a commissioning officer at NHSE’s workforce, training and education directorate – the new HEE – said procurement of new district nursing courses from universities would be paused “until further notice”, due to the “ongoing merger”. Since 2009, the number of district nurses working in the English NHS has fallen drastically, from around 7,000 to around 3,900. Steph Lawrence, executive director of nursing and allied health professionals at Leeds Community Healthcare Trust, said the decision to pause the expansion of courses was a “huge concern” as numbers of district nurses need to grow “at a much faster rate”. “This is a major safety issue for safe and effective care in the community if we don’t have the appropriate numbers of nurses trained. We may also lose nurses as well who want to progress and expand their knowledge,” Ms Lawrence said. Read full story (paywalled) Source: HSJ, 5 June 2023
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News Article
CQC case reveals ‘degrading’ conditions in England care home as Covid hit
Patient Safety Learning posted a news article in News
The depth of suffering in care homes in England as Covid hit has been laid bare in a court case exposing “degrading” treatment with residents being “catastrophically let down”. Care levels at the Temple Court care home in Kettering collapsed so badly in April 2020, when ministers rushed to free up NHS capacity by discharging thousands of people, that residents were left lying in their own faeces, dehydrated, malnourished and suffering necrotic, infected wounds, the Care Quality Commission found. Fifteen of its residents died with Covid in the first weeks of the pandemic. The case foreshadows the UK Covid-19 public inquiry module on the care sector, which next year will test Matt Hancock’s claim to have thrown “a protective ring around social care”. The prosecution resulted in a £120,000 fine handed down at Northampton magistrates court last week. The operator, Amicura, apologised but said it had been “acting in the national interest and supporting the NHS by accepting patients discharged from hospitals into care homes under government policy”. Read full story Source: The Guardian, 29 May 2023 -
News Article
What the NHS is learning from Brazil
Patient Safety Learning posted a news article in News
Knocking on doors to check on people's health and catch problems before they escalate is common practice across Brazil. But could that approach work in the UK? Comfort and Nahima are two out of four door-knockers on round Churchill Gardens, a council estate in the Pimlico neighbourhood of London, visiting residents as part of a proactive community healthcare pilot. They can help with anything from housing issues which impact health, such as overcrowding, or pick up the early signs of diabetes by chatting informally to residents about their lifestyle. These community health workers are partly funded by the local authority and partly by the NHS so they can co-ordinate between the local GP surgery and other social services. Local GP Dr Connie Junghans-Minton says the proactive approach had led to fewer requests for appointments The National Institute for Health Research helped crunch the data from the pilot. Households which had been visited regularly were 47% more likely to have received immunisations and 82% more likely to have taken up cancer screening, compared to other areas. The idea to import this model to the UK came from Dr Matthew Harris, a public health expert at Imperial College London who worked as a GP in Brazil for four years. There, community health workers have been credited with achieving a drop of 34% in cardiovascular deaths. "In Brazil they have scaled this role to such degree that they have 270,000 community health workers across the whole country, each of which looks after 150 households, visiting them at least once a month," Dr Harris said. "They've seen extraordinary outcomes in terms of population health in the last two or three decades. We think we've got a lot to learn from that." Read full story Source: BBC News, 9 May 2023 -
News Article
Covid: Staff propped up care homes without extra pay, says report
Patient Safety Learning posted a news article in News
Many care home staff worked extra hours without extra pay to prop up the system during the pandemic, a study suggests. Public money helped stabilise UK care homes during the first wave of Covid-19 but it was withdrawn too soon and not focused on staff, says the research, led by Warwick Business School. The researchers studied the accounts of more than 4,000 UK care home companies, from just before the pandemic and during the first year of the health crisis. They found nearly two thirds (60%) of care homes were already financially fragile as the pandemic took hold. The report concludes: "The decision by government to end financial support for care home companies after the peak of the pandemic had passed has likely contributed to the current financial and operational difficulties experienced by the sector." It states the financial plight of many staff and the immense pressure they were under "means it is not surprising the care home sector has struggled to both recruit and retain staff once lockdown restrictions were removed and the wider economy re-opened". Read full story Source: BBC News, 12 April 2023 -
News Article
NHS patient 'stuck in hospital with months to live'
Patient Safety Learning posted a news article in News
A woman who may only have months to live has told the BBC she is "angry and frustrated" at being in hospital five months after being cleared to go home. Charlotte Mills-Murray, 34, said attempts to organise care at her family home had been repeatedly delayed. Charlotte lives with intestinal failure caused by a severe form of Ehlers-Danlos syndrome, which weakens her body's connective tissue. She was admitted to St James's Hospital in Leeds in June 2022 following an infection, and a new Hickman line - a tube that allows feeding and the administering of pain relief - was inserted. By November, Charlotte was told she was well enough to be cared for at home, but she remains in hospital following delays in the hiring and training of staff able to support her. With limited access to a hoist which would enable her to use her wheelchair, Charlotte said she had spent 10 months "stuck in bed". Because of the complexity of her condition, Charlotte only has months to live. She believes her situation merits greater urgency because of the increased risk of infection in hospital. Charlotte qualifies for 24-hour home care support through the NHS Continuing Healthcare scheme, but she said decisions over how this would be put in place had been slow and unclear. The BBC has found a 16% rise over the past year in the number of patients in England who are in hospital despite being well enough to leave. The Department of Health and Social Care said it was "fully committed to speeding up the safe discharge of patients who no longer need to be in hospital" and was making £1.6bn available in England over the next two years to support this, on top of £700m of extra funding in 2022 to ease NHS pressures over the winter. Read full story Source: BBC News, 9 April 2023 -
News Article
Inside one hospice as struggling sector faces turning the dying away
Patient Safety Learning posted a news article in News
Hospices will be forced to turn dying patients away because they are struggling with steeply rising costs at a time when the NHS is not increasing funding. Hospices look after 300,000 patients and families every year across the UK. It costs about £1.5 billion a year for them to provide this care, with only a third of that coming from the NHS. The rest relies on charitable donations and fundraising in local communities as well as sales in charity shops. As hospices battle to keep going, the Treasury has rejected pleas for a £30 million rescue package this year. The money, those in the sector say, would prevent some from having to close inpatient units and beds or reduce their hospice-at-home teams, which care for patients in the community. Some are already making staff redundant and getting rid of beds. Toby Porter, chief executive of Hospice UK, said the government was making “a huge avoidable mistake”, adding: “People will have a lesser experience at an incredibly important moment and it will lead to system pressures affecting the whole health system.” Read full story (paywalled) Source: The Times, 26 March 2023 -
News Article
Three in four patients not seen within new target time
Patient Safety Learning posted a news article in News
Data revealed for the first time shows nearly three-quarters of adult patients needing community mental health care are waiting more than four weeks for treatment to start, which is the timeframe that NHS England wants to introduce as a national standard. Figures shared with HSJ also show two-thirds of children needing community care are waiting more than four weeks from referral to treatment. In 2021, NHS England proposed a series of new waiting time standards in mental health, including a four-week standard for non-urgent community care. A lack of new funding, as well as data recording problems, mean the new standards have not so far been introduced, and no timeline set for implementation. Read full story (paywalled) Source: HSJ, 14 March 2023 -
Content ArticleDifficulties discharging over thirteen thousand patients safely are slowing the flow through hospitals while being stuck in hospital when you don’t need medical care is both mentally and physically harmful. People risk picking up hospital acquired infections, muscle loss and impaired mobility, reduced confidence and independence skills. However, according to Gilda Peterson, Leeds KONP and Secretary, End Social Care, there are ten things wrong with the Government's plan to give the NHS £200m to buy beds in care homes, hotels, hospices and independent hospitals.
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Content ArticleCommunity health services help people to stay healthy and live independently at home, but it has proved difficult to realise a long-standing ambition to deliver more services out of hospital. In this Nuffield Trust explainer, Sarah Scobie and Stephanie Kumpunen describe what community services are, who uses and provides them, who pays for them, and some of the challenges they face.
