The government's policy of moving health services out of hospitals into community settings has been the direction of travel for many years. However, this transition is still not happening effectively, with research highlighting an unsustainable reliance on acute care.
Last month, RCN general secretary Dr Peter Carter warned the UK has the longest hospital stays in Europe, while a report by independent health charity the Kings Fund found 39 per cent more patients waited longer than the official four hour waiting time target to be seen in A&E departments during the first three months of this year than during the same period in 2012.
The Kings Fund's research shows almost six per cent of patients admitted to A&E waited longer than the target time - the worst performance for nine years. It concludes that the actual number of people presenting at A&E has not risen significantly, so the issue may be more a question of how the demand for care is being handled.
Speaking as one voice, the NHS Confederation, Academy of Medical Royal Colleges and National Voices have reiterated the case for investing in community services to help people manage their health, stressing the need to proceed in an integrated way.