Monitor has warned providers that schemes to move care out of hospital are not guaranteed to reduce costs or demand pressure.

Moving care out of acute settings should “sit alongside” work on other solutions to deal with rising demand, research conducted by the regulator suggests.

The findings are included in a set of documents to be released today designed to help health economies consider which service changes are most suitable for their circumstances, particularly in planning new care models.

In a summary note to the “care closer to home” toolkit, Monitor says: “Our findings caution against expecting too much from a shift away from hospital settings; this is no panacea.

“Developing schemes to move healthcare closer to home should sit alongside work on other solutions, such as improving internal processes and decision systems within acute hospitals.

community nurse with patient

Moving care out of hospital should ‘sit alongside’ work on other solutions to deal with rising demand, Monitor says

“Our research finds that moving healthcare closer to home will indeed be important in addressing the pressures of future demand and that this may avoid further costs in the longer run.”

It adds: “Even though providers and commissioners should not expect these schemes to deliver savings in the short run, they are important for their potential to meet growing demand in the longer run and to avoid or postpone future capital costs of expanding acute hospital facilities.

“The schemes will need to work effectively with other initiatives designed to address shorter run challenges, such as measures to ease the flow of patients through acute hospitals.”

It is hoped that providers will be able to use the resources to help decision making around reconfigurations needed to align with the new models of care outlined in the NHS Five Year Forward View.

Kelly Lin, senior economist for Monitor, said: “A lot of the work contained here will help the vanguards in the work they are trying to do.”

The documents adds that although schemes to move care out of hospital will be important in addressing longer term needs, they may not be able to address more immediate operational and financial challenges.

The watchdog has used computer modelling to forecast the costs of implementing four types of out of hospital care:

  • telehealth, providing remote support and triaging through a videolink;
  • reablement, which helps patients with complex needs recover at home;
  • enhanced step-up care, where adults can be treated in community day case settings; and
  • rapid response and early supported discharge, where patients recovering from inpatient stays are treated at home.

Monitor will also publish 14 case studies examining areas where care has been moved into community settings to help providers understand the opportunities and challenges of implementing such schemes.

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