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Risks identified to developing community services

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Community services need expanding Major barriers need overcoming for community services

Community nurses need to be more visible and vocal on how models of care can deliver better value, states a new report by the NHS Confederation's Community Health Services Forum.

The report, which looks at how commissioners and providers can develop new community care models in response to NHS England's Five Year Forward View, identifies two key risks that could hinder this development.

The first is that knowledge and understanding of what community and primary care actually does is varied among commissioners and providers. 'It has often lacked prominence in high-profile discussion about the future of healthcare including the Five Year Forward View. The complexity and variability of what community services deliver compounds this problem as does the challenge of developing new models while simultaneously managing unprecedented financial pressures,' the report authors said.

In order to address this, The art of the possible: What role for community health services in reshaping care, outlined several measures. It recommended that community nurses need to become more vocal in shaping models of care, national leaders need to do more to articulate the value of community services and local community service leaders must speak up about the benefits of their services.

Dr Nav Chana, chair of the National Association of Primary Care, said: 'We need to get away from sectors and siloes – the future is about bringing together professionals and services around local populations.'

The second risk factor identified by the forum is that policy barriers to community services growing and maximising their value have yet to be resolved. In order to solve this the report stated that there needed to be nationally agreed measures of the quality and efficiency of community services, clarity about competition and procurement rules and a strategy to overcome workforce shortages and workload pressures in community nursing.

NHS Confederation Community Health Services Forum Chair Matthew Winn said: 'We need truly joined-up, community-based models of care if we are to meet the demands of a 21st century health and care service.

'Everyone involved in developing new care models – commissioners and providers - will need to take a strategic approach to maximising the expertise, innovation and resources in community health services and release the possibilities of working in an integrated way with general practice.

'To create new care models we must not start with organisational structures but instead use the views and insights of patients and the public, and engage community health care and general practice staff, to design a new future.'

The report contains other suggestions to develop primary and community services such as developing teams of nurses and therapists with specialist knowledge of conditions, community services partnering with GP federations to work across larger populations and joint initiatives between community services and care homes.

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