Providing care closer to home

doi:10.1136/bmj.39371.523171.80

BMJ 2007;335:838 (27 October), doi:10.1136/bmj.39371.523171.80

Editorials

Providing care closer to home

The strategy is popular with patients but questions about costand quality remain

The first 150 words of the full text of this article appear below.

The 2006 National Health Service (NHS) white paper, Our health,our care, our say, set out a strategy to provide more servicesin the community, closer to people's homes.¹ The report of theevaluation has just been published,² along with a report fromthe specialties involved.³ The strategy was based on internationalexperience that moving care from large hospitals to smallerlocal sites improves patient satisfaction and outcomes and ismore cost effective. The scheme involves new and more integratedcare pathways, polyclinics that provide a wide range of diagnosticand therapeutic services,⁴ and renewed investment in communityhospitals. Plurality of services, and the system of "paymentby results" by which money follows patients, should enhancepatient choice and incentivise quality and value.⁵

The white paper included a commitment to evaluate the strategyin 30 "closer to home" demonstration sites in six specialties:dermatology; ear, nose, and throat; general . . . [Full text of this article]

Chris Salisbury, professor of primary health care, Sarah Purdy, consultant senior lecturer in primary health care

Academic Unit of Primary Health Care, University of Bristol, Bristol BS8 2AA

c.salisbury@bristol.ac.uk

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