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Alliance warns against “one size fits all” approach to community services

29 January 2010

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A single, “one size fits all” approach to running community services will damage patient care and the integrity of community and primary care, the NHS Alliance today (29 January 2010) warned.

Responding to reports from its members that PCTs are being put under pressure to divest themselves of the community provider function, the Alliance says community services “need transformation”, but a structural quick fix will not help and could, in fact, damage the progress already made in many PCTs.

The primary care body says a tailored solution to community care provision would be best, since “a top down approach to vertical integration … means that community services could end up being managed by those with least experience and vision about community-based care.”

Dr Michael Dixon, NHS Alliance Chairman, said: “Any inflexible steer from above towards vertical integration with acute or mental health trusts and the creation of large hospital monopolies represents a huge step backwards for the NHS.

“It flies in the face of localism and will do nothing to support the drive to greater self help, personal health and improved community health nor the need for more services closer to a patient’s home.

“It is yet another attempt to ‘fix’ the NHS through organisational change and is based on an ignorance of what primary care really does. This approach will only cause disruption, expense and unhappiness for patients, taxpayer and staff. Supporters of this approach have lost the plot.”

Yvonne Sawbridge, joint vice-chair of the NHS Alliance, added: “A one-size-fits-all vertical integration model for community services makes little sense. PCTS need to make the right local decisions for their communities.

“Given that the majority of NHS care is given outside of hospitals, why allow acute services to run community services when their natural home is much more likely to be with social services?

“It is hard to understand how the addition of a new set of responsibilities will do other than distract hospital managers from the core business of continuously improving the patient experience.”

NHS Alliance