1/11 Excellent 1st Community Network dinner w Ian Dalton & @mswindells this week. Whilst respecting Chatham House rule, here's what's on minds of CEOs & Chairs from trusts providing community services. Pleased to be organising Network with our partners from @nhsconfed.
2/11 Community services CEOs worried about amount of time and distraction taken up with constant, frequent, time consuming, contract retendering. They'd far rather be putting that time/energy into improving and delivering services for patients, which is what they're there for.
3/11 Community services CEOs worried about impact on staff of constant retendering. In these workorce challenged times, vital to ensure frontline staff motivated, supported and committed. Difficult to achieve if contracts being frequently retendered and staff changing employer.
4/11 Community services CEOs clear that bringing together community, primary, social and community mental health care at neighbourhood level (c50k population) is key to improving and integrating patient care. Rapid rollout of this model at scale shd be key plank of 10 yr plan.
5/11 Community service CEO worried, in supportive way, about quality of commissioning of community services. Too much concentration on contracts, tendering and counting widgets, not enough on commissioning for outcomes & quality care. This requires expertise that's often lacking.
6/11 Cmmnty ser CEOs worried about block contracts & where they sit in CCG financial priority queue. Real sense of "pay for increased acute volumes via PBR first; must meet mental health commitment; what's left, oh, we'll have to cut community block contract to hit CCG budget".
7/11 Comm ser CEO feel their services lose out because there isn't the same quality, width & regularity of robust service level data that national system leaders concentrate on. Interesting debate abt whether more/better data needed or better naitonal focus on data that's there!
8/11 Some comm ser CEOs woried that over ambitious GP federations are looking to takeover community services they may not have capability to actually run. Integrating primary & community care vital but danger of creating even more of a "swiss cheese" pattern of service delivery.
9/11 Lots of debate between community service CEOs and national leaders about what the best level of homogeneity / heterogeneity of community services should be. A single uniform pattern across country or accepting that existing pattern works well in many areas, so why change?
10/11 Real worry from CEOs that there is very significant, invisible, unmet need in community servives that we simply can't see in the way we can in acute services and increasingly can in mental health (though long way to go in latter) due to the data that's focussed on.
11/11 Strong agrement @ Community Network dinner that providing much more, quality, personalised care at home/in the community with a strong emphasis on prevention, integration and long term condition managemnr is only way to beat impending doom of rapidly rising demand.
