Evidence Submission: Care Closer to Home

The previous Labour government developed the Care Closer to Home initiative in response to a need to move health and social care out of institutions such as hospital, and into community settings. The programme aimed to reduce demand on acute hospital services, whilst also improving patient choice and convenience. It was also seen to address the high costs of providing care for an ageing population within the acute sector.

The Department of Health funded Care Closer to Home demonstration sites, together with a national evaluation, conducted by a team at the University of Manchester. The evaluation used a mixed methods design, combining an observational study with qualitative methods. The evaluation found that the Care Closer to Home initiative showed considerable potential to move care into the community and so improve access and convenience to patients. However, it concluded that important issues, such as quality, safety, cost and staff training, need to be considered as community based services are expanded.

This report, by the Making the Most of Evaluation research group, looks at the evaluation and appraises the type of evidence it provides and its findings. It found that the evaluation was limited by the lack of a formal comparison group, insufficient data about costs and an absence of information about patient outcomes.  The demonstration sites were small and the evaluation provided only limited evidence about the costs and benefits of the policy, but did highlight important issues that need further attention.

The report concluded that the policy should not be rolled out more widely without consideration of implementation, costs, quality and training.

Click here to read the report in full and you can read the summary report of all the reviews here.