Recent Studies

The CHA has been pleased to support a number of studies on community hospitals, looking at topics such as value, international learning, efficiency and safe discharge practice.

Value of Community Hospitals

Professor Jon Glasby University of Birmingham

Professor Jon Glasby University of Birmingham

Professor Jon Glasby

Analysis of the profile, characteristics, patient experience and community value of community hospitals

Davidson D, Ellis Paine A, Glasby J, Williams I, Tucker H, Crilly T, et al . Analysis of the profile, characteristics, patient experience and community value of community hospitals: a multimethod study. Health Serv Deliv Res 2019;(1)   

The key findings of the study describe community hospitals as providing integrated services in a model of embedded relational care, offering reassurance.  The findings of the study with regard to patient and carer experience was overwhelmingly positive. The CHA views the study and the report as an important contribution to the planning and management of health care services, offering new knowledge and evidence on the role that community hospitals have to play across the whole health and care system, and also within their communities.  It is hoped that the evidence will be of value to all concerned with community hospitals, and in particular commissioners, providers, patients and their communities.  The CHA was on the project board and steering group for this study and also on the project team. The CHA was pleased to contribute to this important study.

Link:  https://www.journalslibrary.nihr.ac.uk/hsdr/hsdr07010#/abstract

Illustrated Scientific Summary
Link:  http://www.communityhospitals.org.uk/Illustrated%20Scientific%20Summary.pdf

Publications from the study

Seamark, D., Davidson, D., Ellis-Paine.A., Glasby, J., Tucker,H.  (2019)    "Factors affecting the changing role of GP clinicians in community hospitals: a qualitative interview study in England."  British Journal of General Practice 2019; 69 (682): e329e335. DOI: https://doi.org/10.3399/bjgp19X701345

Dr David Seamark with the research team has published an article on the changing role of GPs in community hospitals. The variety of clinical arrangements are described in the study. The study describes the role of GPs as a driving force in the development of community hospitals, and their experience as typically positive. However multiple factors have led to many GPs losing their involvement in their local hospital. The study concludes that a focussed strategy is needed if GPs are to remain engaged in community hospital work. 

Link: https://bjgp.org/content/69/682/e329/tab-article-info

Davidson, D., Williams, I., Glasby J. (2021) "Localism and Intimacy, and… Other Rather Imponderable Reasons of That Sort": A Qualitative Study of Patient Experience in Community Hospitals in England.  A pre-print. 
June 2021     DOI: 10.21203/rs.3.rs-583651/v1

The study suggests the need to weigh 4 dimensions of patient experience (functional, relational, social and psychological) when assessing the role and contribution of community hospitals.  When considered together, the authors conclude that these four elements point to community hospitals as providing a primarily embedded and relational, rather than transactional, model of care.  

Link:  https://www.researchgate.net/publication/

Professor Jon Glasby Video provides an overview of Community Hospitals and the study
https://www.youtube.com/watch?v=XA1czkz2cBA

Discovering a New Model of Care – Viewpoint, University of Birmingham
Dr Helen Tucker

The challenge will be to find ways of developing new models of care that retain those features of community hospitals that are so highly valued by local people, and which make a significant contribution to the health care system.  Community hospitals have been shown to have a long tradition of local, accessible generalist care that can be provided to mainly rural communities in a sustainable way. This "old" model of care with its long tradition should not be overlooked, and ways found in which community hospitals have a strategic role and can be seen to be an integral part of "new" models of care.

Link https://www.birmingham.ac.uk/schools/social-policy/departments/health-services-management-centre/news/viewpoint/2017/12/Community-Hospitals-%E2%80%93-Discovering-a-New-Model-of-Care.aspx

Kamerāde, D., Mohan,J., (2015)  Mapping community-based financial charitable support for community hospitals in England and Wales 1 : first findings Working paper 133   Third Sector Research Centre, University of Birmingham

Daiga Kamerāde and John Mohan from the Third Sector Research Centre at University of Birmingham analysed the financial support received by community hospitals.  They concluded that"Community hospitals receive a substantial financial support from their communities; however, this support has been declining is sensitive to macroeconomic changes - while it is generous during economic growth, it can substantially decline during economic recessions.

http://www.communityhospitals.org.uk/pdf/Birmingham/CH_Kamerade_Mohan_TSR133.pdf


International Learning and Community Hospitals

Ellen Nolte RAND Europe and University of Bournemouth

Professor Jon Glasby University of Birmingham

Ellen Nolte

Pitchforth E, Nolte E, Corbett J, Miani C, Winpenny E, van Teijlingen E, et al. (2017)   Community hospitals and their services in the NHS: identifying transferable learning from international developments - scoping review, systematic review, country reports and case studies. Health Serv Deliv Res 2017;5(19)

The study shows that collaborative working is a key characteristic of community hospitals. The study shows that Community Hospitals are at the interface between primary care and specialist care, and community hospitals have the potential to play a major role in the management of acute and non-acute conditions.  They are an integral component of local health care delivery systems.  The evidence suggests that a more strategic role for community hospitals might be timely within NHS England. There is potential for community hospitals to be better integrated into the current healthcare system in England to offer an effective and efficient alternative to acute hospitals and to provide care health and social care closer to people's homes.

Link: https://www.journalslibrary.nihr.ac.uk/hsdr/hsdr05190#/full-report

Publications from the study

Winpenny EM, Corbett J, Miani C, King S, Pitchforth E, Ling T, et al.  (2016) Community Hospitals in Selected High Income Countries: A Scoping Review of Approaches and Models. International Journal of Integrated Care. 2016;16(4):13.

Community hospitals are able to provide a diverse range of services, responding to geographical and health system contexts. Their collaborative nature may be particularly important in the design of future models of care delivery, where emphasis is placed on integration of care with a key focus on patient-centred care.

Link: https://www.ijic.org/articles/10.5334/ijic.2463/


Optimising Community Hospital Care

Professor John Young. University of Leeds

Ellen Nolte RAND Europe and University of Bournemouth

Professor John Young

The CHA was pleased to work with John Young and his team on this study.  This area of investigation represents the most frequently asked questions about community hospitals from our network – efficiency and cost.  This is an important piece of work, and adds to the evidence base on the performance and contribution of community hospitals. 

Young, J., Godfrey, M., Teale, E., Hulme, C., Smith, A., Bucknell, J., Enderby.P., Gladman, J., Tucker, H. et al. A Study to understand and Optimise Community Hospital Care in the NHS: the Models of Community Hospital Activity (MoCHA) Study Health Serv Deliv Res 2019 

The study found that the efficiency of community hospital wards is comparable with acute hospitals and that modifiable performance factors might lead to potential efficiency savings.   

Link: https://www.journalslibrary.nihr.ac.uk/hsdr/hsdr08010/#/abstract

Publications from the study

Toolkit

The study also involved designing a toolkit with the NHS Benchmarking Network,  to support operational changes to optimise community hospital ward care for older people.

http://mocha.nhsbenchmarking.nhs.uk/main


Optimising Safe Discharge Practice in English Community Hospitals

Andrew Mitchell. University of Birmingham

Andrew Mitchell

Andrew Mitchell

Optimising Safe Discharge Practice in English Community Hospitals: A qualitative study Health Management and Leadership (BMedSc) 2021

Four themes which influence how safe discharge practice is optimised were identified: Wider system influences, personalised planning, value of the multidisciplinary team and Community Hospital experience. Community hospital discharge practice is optimised by mitigating discharge risks. Staff should provide a holistic approach towards planning and assessment, frequently collaborate amongst CH MDT members, and tailor care towards older patient demographics in CHs.  Andrew has been supported by the CHA, and in particular by Dr David Seamark.

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