As part of the
English NHS programme of separating the provision of services from commissioning known as
Transforming Community Services a number of community health trusts were established when these services were separated from
primary care trusts.
This was one of a number of options taken. In some places community services were transferred to an existing
mental health trust
A mental health trust provides health and social care services for people with mental health disorders in England.
There are 54 mental health trusts. They are commissioned and funded by clinical commissioning groups.
Patients usually access th ...
or
hospital trust
An NHS trust is an organisational unit within the National Health Services of England and Wales, generally serving either a geographical area or a specialised function (such as an ambulance service). In any particular location there may be several ...
. In South West England there was considerable pressure for staff to establish
social enterprise
A social enterprise is an organization that applies commercial strategies to maximize improvements in financial, social and environmental well-being. This may include maximizing social impact alongside profits for co-owners.
Social enterprises ha ...
s such as
Peninsula Community Health to take on these services.
Campaigners in
Gloucestershire
Gloucestershire ( , ; abbreviated Glos.) is a Ceremonial counties of England, ceremonial county in South West England. It is bordered by Herefordshire to the north-west, Worcestershire to the north, Warwickshire to the north-east, Oxfordshire ...
successfully challenged the decision to establish a social enterprise to provide community health services there in 2012.
Contracts to run NHS community services are subject to competitive tendering processes under the
Health and Social Care Act 2012
The Health and Social Care Act 2012 (c. 7) is an Act of Parliament (UK), act of the Parliament of the United Kingdom. It provided for the most extensive reorganisation of the structure of the National Health Service (England), National Health Ser ...
, so it is not clear whether these organisations will survive. The NHS community health services sector, not including mental health services, is said to be worth £9.7 billion - about 10% of the entire NHS budget. This is the sector in which competition from private providers such as
Virgin Healthcare and
Serco
Serco Group plc is a British multinational corporation, multinational military, defence, Healthcare, health, Space industry, space, private prison, justice, Human migration, migration, customer service, customer services, and transport company ...
is most intense. There is a great deal of pressure to move NHS services out of hospitals and into the community, but up to now most of these services have been funded by block contracts. There are measures of activity but no outcome measures and no
NHS tariff, so there is no financial incentive for providers to ensure services are effective. it remains to be seen what impact the instigation of
Any Qualified Provider contracts will have on this sector.
Community services have been repeatedly reorganised since the abolition of
district health authorities in 1996. Established as NHS trusts, they were under the same imperative to become
NHS foundation trust
An NHS foundation trust is a semi-autonomous organisational unit within the National Health Service (England), National Health Service in England. They have a degree of independence from the Department of Health and Social Care (and, until the a ...
s as existing trusts, but it seems unlikely that many of them will be able to pass the tests in their present form.
Community healthcare trusts may provide services including:
*
District nursing, including out of hours nursing
*
Health visiting
*
School nursing
School nursing, a specialized practice of public health nursing, protects and promotes student health, facilitates normal development, and advances academic success. School nurses, grounded in ethical and evidence-based practice, bridge the gap b ...
*Community
physiotherapy
Physical therapy (PT), also known as physiotherapy, is a healthcare profession, as well as the care provided by physical therapists who promote, maintain, or restore health through patient education, physical intervention, disease preventio ...
*
Speech and language therapy
Speech is the use of the human voice as a medium for language. Spoken language combines vowel and consonant sounds to form units of meaning like words, which belong to a language's lexicon. There are many different intentional speech acts, suc ...
*Community
podiatry
Podiatry ( ), also know as podiatric medicine and surgery ( ), is a branch of medicine devoted to the study, diagnosis, and treatment of disorders of the foot, ankle and lower limb. The healthcare professional is known as a podiatrist. The US ...
Free-standing community health trusts existing in 2013
*
Birmingham Community Healthcare NHS Trust
*
Bridgewater Community Healthcare (based in
Wigan
Wigan ( ) is a town in Greater Manchester, England. The town is midway between the two cities of Manchester, to the south-east, and Liverpool, to the south-west. It is the largest settlement in the Metropolitan Borough of Wigan and is its ad ...
)
*
Cambridgeshire Community Services NHS Trust
*
Central London Community Healthcare NHS Trust (also provides services in Hertfordshire)
Croydon Community Health Services*
Derbyshire Community Health Services NHS Trust
*
Gloucestershire Care Services NHS Trust
*
Hertfordshire Community NHS Trust
Hounslow and Richmond Community Healthcare NHS Trust*
Kent Community Health NHS Foundation Trust
*
Leeds Community Healthcare NHS Trust
Lincolnshire Community Health Services*
Liverpool Community Health NHS Trust
*
Medway Community Healthcare
*
Norfolk Community Health and Care NHS Trust
*
Shropshire Community Health NHS Trust
*
Sussex Community NHS Trust
* Tameside and Glossop Community Healthcare
*
Wirral Community NHS Trust
References
{{reflist
National Health Service (England)