Briefing / The impact of Covid-19 on the future delivery of NHS community services

NHS community services have played a key role in the overall NHS response to Covid-19. At the very early stages of the pandemic, providers of community services were asked to support the rapid discharge of patients from acute settings as beds were emptied in anticipation of increasing Covid-19 cases.

So far during the pandemic, NHS community services have supported many people to stay well and stay at home or be cared for in the community. Through doing this, they have been a vital part of the system response by keeping people away from acute settings, enabling a focused Covid-19 service to be delivered and the expansion of intensive care units into other hospital areas. Many organisations have reported improved relationships with local partners in the acute sector and social care, with noticeable changes to the efficiency of system working and governance processes. Staff flexibility has also been welcomed, with workforce transferring between settings to support the needs of patients. There is much to celebrate in the response of NHS community services, and their wider systems, to Covid-19.

However, this support has also had implications for NHS community services, as Covid-19 has had for all parts of the health and care system. The acuity of patients in the community increased, placing additional demands on staff. Some community services had to be stopped or much reduced in order to redeploy staff to care for those discharged from hospital. As the pandemic progressed, this support extended to those recovering from Covid-19 in the community, supporting primary care services and care homes as well as people in their own homes. In addition, the way that services were delivered had to change. As for much of the NHS, there was a rapid take up of digital methods in community services with virtual and telephone consultations replacing face to face contact.

As Covid-19 will be present for some time to come, services need to be restored at the same time as maintaining, and increasing, the additional services put in place to address the demands of Covid-19. While many of these begin to address the ambitions for community services in the NHS long term plan, funding them is difficult with many NHS community providers having to make difficult choices about what level of services can be sustained.

This briefing looks at what Covid-19 means for the future of NHS community services. In this context, NHS community services means community services funded by the NHS. These services may be delivered by NHS provider organisations, social enterprises or the independent sector. It considers the role of community services in the future NHS; how the sector can meet existing, and new, demands and the resources that are needed in order to do this well.