Guidance

Moving healthcare closer to home

Support for providers and commissioners to make evidence-based appraisals of how the benefits compare with the costs of various approaches to move care closer to home.

Applies to England

Introduction

The has encouraged efforts to deliver more healthcare out of acute hospitals and closer to home, with the aim of providing better care for patients, cutting the number of unplanned bed days in hospitals and reducing net costs.

Providers and commissioners considering strategic changes to the way in which services are delivered need to agree what they wish to achieve and understand the range of options. They then need to be able to assess the impact on quality and outcomes for patients and finances for the local health economy of each scheme.

To support this decision-making, we ran a project to examine cases where provision of non-elective care moved from an acute hospital to the community. We then developed the resources below to support the sector in planning new care models. This includes a summary of our findings, details of our analysis, practical tools to support providers and commissioners and a set of case studies on schemes to avoid emergency admissions to acute hospital or to discharge patients more quickly.

Summary

Delivering more healthcare services closer to home rather than in acute hospitals is a new aproach being reviewed by the sector. Schemes to do this, when well designed, can help local health economies manage capacity and may help avoid costs in the long run. Find out:

  • why we did this project
  • what we looked at
  • how we analysed the data
  • our most important findings and conclusions

(PDF, 523 KB, 13 pages)

Literature review of clinical impacts

A summary of evidence on possible quality and outcome impacts for patients of providing care in community-based settings rather than hospital, based on searches in PubMed, life science journals and online books.

(PDF, 476 KB, 17 pages)

Financial impacts

Findings on how 4 types of schemes (to avoid acute hospital admissions or speed up discharge) affect costs in a typical suburban health economy, alongside data on the costs and impacts of these schemes.

(PDF, 1.01 MB, 41 pages)

Implementation considerations

How providers and commissioners have tackled the 5 most frequently mentioned implementation challenges.

(PDF, 627 KB, 20 pages)

NHS talks: why move care closer to home?

Monitor talks to NHS foundation trust staff about their experiences in delivering community-based healthcare schemes.

Discussing the challenges

Hear from NHS staff who have delivered schemes in our , and share your own experiences or questions.

Case studies

15 case studies that describe schemes to avoid hospital admissions, enable early discharge or reduce length of stay through improving acute pathways.

Case studies by theme

We鈥檝e grouped the case studies by theme so that you can read the ones that are most useful to you and your organisation.

  • (PDF, 206 KB, 13 pages)
  • (PDF, 325 KB, 35 pages)
  • (PDF, 225 KB, 11 pages)
  • (PDF, 253 KB, 23 pages)

Case studies: collection of all 15

Download the whole collection of case studies.

(PDF, 601 KB, 75 pages)

Individual case studies

  • (PDF, 174 KB, 5 pages)
  • (PDF, 179 KB, 6 pages)
  • (PDF, 127 KB, 6 pages)
  • (PDF, 170 KB, 5 pages)
  • (PDF, 131 KB, 6 pages)
  • (PDF, 213 KB, 6 pages)
  • (PDF, 177 KB, 5 pages)
  • (PDF, 169 KB, 4 pages)
  • (PDF, 165 KB, 4 pages)
  • (PDF, 179 KB, 6 pages)
  • (PDF, 172 KB, 4 pages)
  • (PDF, 114 KB, 4 pages)
  • (PDF, 106 KB, 3 pages)
  • (PDF, 164 KB, 4 pages)
  • (PDF, 121 KB, 5 pages)

Considerations for providers and commissioners

A quick overview of key resources that providers and commissioners can use to be more strategic when implementing different schemes to move healthcare closer to home.

(PDF, 211 KB, 1 page)

Updates to this page

Published 9 September 2015

Sign up for emails or print this page