Reflections from recent AoMRC roundtable

We recently sponsored a roundtable with the Association of Medical Royal Colleges on ‘Shifting the future of care and taking the public with us’. The event was attended by presidents of medical royal colleges, thought leaders including the Chief Executives of the Kings Fund and the Nuffield Trust, and leaders from the health and care systems in Manchester and in Greenwich.

The conversation was really rich; there was a recognition that the conversation on shifting to the community has been on going for decades and so it was inspirational to hear from people who are actually making the shift happen.

Sohail Munshi, Chief Medical Officer with Manchester and Trafford Local Care Organisations, described his experience leading the implementation of Hospital at Home in Manchester, which brings secondary care resources out into community settings. This programme has shown that the care provided through a virtual ward model improves patient experience and outcomes. Reflecting on this, Dr Munshi argued that we need to start the drive to action by asking what is the right thing to do for, and in collaboration with, patients. This shift will not immediately create cost-savings, so money cannot be the driving factor. However improving outcomes will create financial benefits in the medium term.

The discussion throughout the session really focused in on the purposeful actions we need to take to drive this shift at scale. Some of the key actions which jumped out were:

• Systems need to come around, and commit to, a shared ambition for improving outcomes by moving resources into the community
• For systems to be accountable there needs to be a centrally determined set and proportionate metrics which track whether the shift is happening
• Within local systems, the community-based offer is often fragmented, so structural and commissioning decisions are required to make this offer easier to access

The attendees also had an ask for Westminster: government must signal that the shift to community is important and urgent, and this must be backed up through commitment and focus in the policy landscape.

A report from the conversation will be forthcoming soon, we look forward to sharing this with you.