Professor Jon Glasby
Professor of Health and Social Care
Jon Glasby, Professor of Health and Social Care. Areas of work include inter-agency health and social care, direct payments and individual budgets and community care.
Shifting care from hospitals to the community
A review of lessons from previous initiatives to improve patient flow and shift care from hospitals to the community.
Current government policy seeks to make ‘three strategic shifts’:
- Moving care from hospitals to communities
- Making better use of technology
- Preventing sickness, not just treating it
The focus here is on the first of these aims. While shifting care has long been a policy aspiration, previous attempts are widely perceived to have been insufficient to rebalance the health care system. Some argue that the balance may even have shifted the other way, inadvertently serving to prioritise hospital-based care at the expense of primary care and community-based support.
However, this is not for the want of trying – for more than 20 years different governments have been trying to achieve a similar aim, with lots of scope to learn from previous policy and experience.
Against this background, the University of Birmingham’s Health Services Management Centre (HSMC), Department of Social Work and Social Care (SWSC) and Centre for Evidence and Implementation Science (CEIS) were asked by UK Research and Innovation (UKRI) to produce this review of previous attempts to shift care. The review included:
- A policy roundtable for former policy makers, leaders and researchers involved in previous attempts to shift care
- A review of key policy documents since the election of New Labour in 1997
- A rapid review of the academic literature since 2000
This project is funded by UKRI.
Research objectives
Research objectives
To synthesise existing knowledge (practical, experiential and research) in order to identify:
- Successful initiatives aimed at improving patient flow and/or shifting care from hospitals to the community
- Key lessons learned
- Key gaps in evidence
- Implications for future policy and research
Throughout, the emphasis was on strategic and systemic attempts to shift care, rather than on the myriad of individual, small-scale pilot projects that may have existed at any one moment in time.
The review was commissioned by UKRI as part of their Research & Development Mission Accelerator Programme (RDMAP), which seeks to accelerate the impact of research and development towards specific government ‘missions’.
Research team
Professor Amy Grove
125th Anniversary Chair
Amy is a Psychologist and Professor of Implementation Science. As a leading methodologist, she evaluates health technology and innovation to directly impact health service design and delivery
Professor Ross Millar
Director of the Health Services Management Centre (HSMC)
At HSMC Professor Ross Millar he has been involved in a variety of policy evaluations that include examining the impact of market based reform, the promotion of social enterprise in health and social care.
Professor Martin Powell
Professor of Health and Social Policy
Martin Powell, Professor of Health and Social Policy, HSMC. Areas of work include health policy, decentralisation, partnerships, history of health care before the NHS.
Dr Arabella Scantlebury
Associate Professor
Arabella Scantlebury is a Associate Professor in Health Services Management Centre, College of Social Sciences
Supporting members include:
- Adel Elfeky-Research Fellow
- Rachel Posaner-Knowledge & Evidence Service (KES) Manager in Health Services Management Centre
This work was supported by the (NHS Fit for the Future) R&I Mission as part of the UKRI R&D Missions Accelerator Programme.