After several years as a Cinderella service, the tide has turned for community hospitals. They are now recognised as providing a vital link for developing and extending services outside acute hospitals and closer to home, NHS Alliance chairman Dr Michael Dixon told the Community Hospitals Association annual conference in Gloucestershire.
The question is: who will run them? As they become more central to local healthcare, attracting new government investment – and £750m capital funding is not to be sneezed at, Dr Dixon says – then they also become attractive to existing and new providers. Foundation Trusts and private sector companies are waiting in the wings.
Top of the list of the Department of Health design principles for new community hospitals is the requirement that they should be locally led. Certainly they will need close working relationships and joint planning with their local practice-based commissioners if they are to flourish.
The NHS Alliance believes the best solution is, wherever possible, for community hospitals to be owned within and by their local communities. Some are already moving in that direction. GPs in Gloucestershire have approval for a new Social Enterprise Trust that will save the Forest of Dean community hospital from possible closure.
It is working closely with the local PbC cluster. In Hertfordshire, there are similar plans for the Harpenden Memorial Hospital, with local community ownership. Dr Dixon said: "Community hospitals need to be inextricably linked to their communities and GP services, to local selfhelp and personal health initiatives, and be part of the fabric of regenerating local community health.
"If they fall into the hands of those whose motive is profit motive or who are trying to protect other parts of their business, we will lose that strong local commitment and NHS ethos that has been the very strength of community hospitals in the past.
"We must build on these traditional values. Where PCTs are planning to devolve their community hospitals, local people and professionals must work fast and furiously to develop plans that will keep their community hospitals truly local.
"Strong local leadership, financial and organisational expertise and substantial financial backing will be required. The effort is worthwhile."