Report

Making care closer to home a reality

This report from UK think tank the King’s Fund sets out the wholesale shift in focus needed to bolster primary and community care.

The health and care system in England must shift its focus away from hospital care to primary and community services if it is to be effective and sustainable. Despite successive governments repeating a vision of health and care services focused on communities rather than hospitals, that vision is very far from being achieved.

This research explored the underlying factors that have prevented change, and what might need to be done to achieve the vision; we analysed published evidence and national datasets, and interviewed stakeholders across the health and care system. We found that to achieve the vision, political and other national leaders will need to completely shift their focus away from hospitals towards primary and community health and care – and all policies and strategies must align to that focus.

This report is not about closing hospitals or moving existing services from one location to another, although the latter option may sometimes be appropriate. Rather, it is about a wholesale shift in the focus towards primary and community health and care across the domains of leadership, culture and implementation. This will free up every sector to provide the care that it is best equipped to deliver.