'From hospital to community' panel – 'Re:Imagining Health' conference
Director of Policy and Research
As people live longer with more complex health needs, delivering more care in community settings is becoming urgent. At this ‘Re:Imagining Health’ conference panel, kindly sponsored by UCB, system leaders from NHS England and Camden Council explored what it will take to make the Government’s ambition to shift care into the community a reality.
Here are three insights from the panel that struck me as important:
- Integration matters more than the debate over who ‘owns’ it
A recurring theme was the need for integrated care, not just across NHS services, but across data, local government, and communities. But integration doesn’t require a single top-down blueprint. “It doesn’t really matter which bit of the system is the ‘integrator organisation’”, as Kirsten Watters emphasised. What matters is that someone takes responsibility locally for making the system feel joined up. True community-based care needs “whole-population, whole-pathway” thinking, with flexible leadership and a focus on outcomes that matter to people, not just services.
- The digital and data architecture is still holding us back
The audience heard how the health system is still grappling with “siloed and fragmented data sources which are incomplete and inconsistent.” Panel members were clear that meaningful reform needs a new digital and data architecture that makes it easier to deliver care. As Dr Alec Price-Forbes said, “we have to make it easy” for people, both professionals and patients, to adopt new ways of working. That includes normalising better data quality, workforce training, and a culture that shares data appropriately and transparently with communities. We have been talking about this for a long time, after all.
- Radical change is happening… but only where leaders are brave enough to cut against the grain of the current system
Across the country, innovative models of neighbourhood-based care are emerging, but often only in places where leaders are pushing against the grain. In the words of Dr Minal Bakhai, “we need a coalition of the determined”, calling for “maverick leadership” that drives a “left shift” toward prevention and community care, even when the system doesn’t make it easy. These leaders are building trust, empowering individuals, and working in partnership with community assets, often by creating a “permissive culture” that enables staff to try new approaches.