Shifting the balance of care…and making the money add up

Abstract

Purpose A critical commentary on policy and practice over time in English health and social care. The paper aims to discuss these issues. Design/methodology/approach Personal reflections based on prior experience as a senior leader in the English health and care system, combined with insights and relevant evidence from other senior leaders and health and care “think-tanks”. Findings Shifting the balance of care from a hospital to a community setting can potentially be cost-effective as well as improving quality for service users. However, it will require a change in the approach to planning and implementation, by focussing on service users and communities, rather than on statutory organisations. It will also require a greater level of integration between primary care, community health services, social care and the voluntary sector, and greater levels of “co-production” with service users and the public. Research limitations/implications Front-line health and care leaders are generally unaware of the evidence base in this field. Emergent findings in this field need to be rapidly evaluated and then communicated to front-line leaders and practitioners. Originality/value Incorporates direct experience of senior leaders in the field together with the existing and emerging evidence base.