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Almost half of community care funded by non-NHS contributions

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53% of community care is NHS-funded 53% of community care is NHS-funded with the rest coming from other outside sources

Almost half of the financial value of community care is provided by sources outside of the NHS, a report has revealed.

Around £10 billion was spent on NHS community care in 2016/17, for services such as community nursing, health visiting and occupational therapy. Analysis by the Health Foundation showed that the while the biggest contracts for community care are held by NHS providers, the health service is also reliant on services offered by charities, local authorities and private sector companies.

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NHS providers hold over half (53%) of the annual financial value of the contracts for community care awarded by the health service. Private providers were awarded 5% of the total value of the contracts, the third sector (charities) were awarded 2% and GPs were awarded 1% of the value.

The remainder went to ‘other’ providers (36%) – a diverse group made up of community interest companies, social enterprises, local authorities and others reported as non-NHS. Most contracts are short-term and the majority of non-NHS contracts are for relatively small sums.

However, looking at the number of contract shows a different picture, with private providers holding more contracts (39%) than NHS providers (21%). GPs held 12% of contracts, the third sector 11%, and other providers 13%.

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Adam Roberts, Head of Economics at the Health Foundation, said: ‘The vast majority of people believe in a national health system that is tax funded, free at the point of use and which provides comprehensive care for all citizens. But there is less consensus when it comes to who provides the care, with two fifths of people saying they prefer their care delivered by the NHS, and a slightly higher proportion (43%) who do not have a preference.

‘Regardless of who is providing NHS community care, contracts for these services – which include community nursing, health visiting and occupational health – need to ensure care is delivered efficiently and to a high quality, while encouraging long-term planning.’

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Contracts awarded to NHS providers tend to be of higher value then those for non-NHS providers. The average annual contract value for the NHS was over £3.5million. For the private sector it was £200,000.

Involvement of non-NHS providers in community care has grown rapidly in recent years. In 2010/11, data from primary care trust accounts showed that non-NHS providers accounted for 20% of all community care spending. In 2012/13 the figure was 31%. The Health Foundation’s latest research shows 47% was provided by non-NHS providers.

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