University of Birmingham

Summary of Research Study

Research studies have shown that older people treated in community hospital wards do better than people treated in general hospitals. However, two national surveys by NHS Benchmarking have shown that measures of community hospital care such as staffing, leadership, lengths of stay, outcomes and costs vary greatly between community hospitals. It is not known why such differences occur, or how they affect the quality of care and costs. A popular (and possibly cheaper) alternative to the community hospital ward is short-term rehabilitation in residential care homes but differences in results for patients and costs between the two types of services are unclear. Our proposed study will address these issues.

We will use NHS Benchmarking surveys and National surveys. We will analyse the survey results and refine our findings with a special panel of patient representatives and experts to develop a classification system of community hospital wards based upon the important characteristics affecting the quality of patient care and costs. We will then use the classification system to select 3 community hospital wards for very detailed studies in which local ward teams will work in partnership with the research team to further improve our understanding of the characteristics of an ideal community hospital ward. We will then be in a position to survey by post all the UK community hospitals. We also plan to use the NHS Benchmarking surveys to compare results and costs between community hospital wards and short term rehabilitation in residential care homes. NHS Benchmarking are experienced in the development of quality improvement toolkits and we will produce a web-based toolkit available to NHS teams to collect, analyse and review the characteristics of their community hospital wards and help them to develop a plan to improve the quality of care provided.


The main benefit of our study is to ensure that older people who need rehabilitation in community hospital wards get the same high standard of care regardless of where they live. We will be able to describe the characteristics of a community hospital ward that lead to good outcomes for patients and for the tax payer. We will develop a toolkit to enable NHS teams to improve the service they provide.

Our team is well placed to carry out this research as it consists of members with considerable expertise in the health care of older people, patient involvement, health economics, and in conducting national surveys and qualitative types of research.


Key Steps

The objectives of the project will be achieved through four inter-related studies:

Study 1: Cost efficiency modelling (health economics study) using anonymised National Audit of Intermediate Care and NHS Benchmarking Community Hospitals Project dataset's.  
Study 2: National community hospital survey (co-produced with the Community Hospital Association)
Study 3: In depth case studies at a pre-determined selection of community hospitals across England and Wales (quantitative and qualitative study)
Study 4: Development of web-based quality improvement toolkits