Moving Services out of hospital: Joining up General Practice and community services?

Closer collaboration between primary care and community health services is a clear objective of the most recent NHS reforms. Currently, there is much emphasis on integrating healthcare

services and in particular, moving care closer to home and out of the acute care setting by utilising Community Services and Primary Care.

This report summarises the findings of a rapid review undertaken by PRUComm of the available evidence of what factors should be taken into account in planning for the closer working of primary and community health/care services in order to increase the scope of services provided outside of hospitals. We synthesised the findings of recent reviews of the published literature seeking to examine evidence relevant to answering the question:

What factors should be taken into account in planning for the greater integration of primary and community care services in order to increase the scope of services provided outside hospitals?

We examined evidence focused at three different levels:

Micro-level – factors affecting the effectiveness of multidisciplinary team-working

Meso-level- the impact of service organisation and delivery issues, including population coverage and service location

Macro-level – structural issues, such as ownership models and financing