Schemes that deliver healthcare closer to home are often better for patients but largely fail to save the NHS money, according to a review of evidence by the Nuffield Trust.
The Trust’s review looked at the evidence for 27 of the most common initiatives to move care out of hospital, such as general practice staff having access to diagnostic tests, and the use of ‘virtual wards’ to support patients in the community. The review found that that the majority of the initiatives have the potential to improve patient outcomes and experience, but only seven of them were proven to save money. Many of the schemes delivered no savings and in the case of six schemes, the evidence reviewed suggested that they were likely to increase overall costs on the NHS.
‘Out-of-hospital care is often better for patients and is the right aspiration for the NHS given the growing and ageing population. But it is not likely to be cheaper for the NHS in the short to medium term,’ said Candace Imison, director of Policy at the Nuffield Trust.
Seven initiatives were found to save money. These includes additional support to people in nursing homes; better support at the end of life; and giving general practice staff better access to specialist expertise such as dermatologists. According to the review, the schemes that were most successful targeted specific groups of patients, such as those in care homes, involved patients in their care, as well as providing training to staff
‘The wider problem remains that there isn’t enough money in the system both to invest in these schemes and to pay for the hospital care of thousands of extra patients every year,’ added Ms Imison. ‘In the context of the tight squeeze on primary and community care and the workforce crisis across the NHS, policymakers need to support Sustainability and Transformation Plan to invest in out of hospital care. That will mean accepting that the system needs the time, money and space to innovate and experiment with new services.’