The World Health Organization (2024) and past governments in the UK have outlined a vision for providing personalised care closer to where people live within their local communities. Yet, this concept has never become a sustainable reality. Indeed, the data from NHS England and NHS Improvement from January 2022 estimated that over 900 000 children and adults were waiting for care within community services' backlog, compounded by the pandemic (NHS Confederation, 2022). The key components of the English healthcare system remain centred around hospitals and emergency care. However, in their recent report, The King's Fund, reignite a refocused model of community-centric health and care provision: Making care closer to home a reality: refocusing the system to primary and community care (The King's Fund, 2024). To make this practical, they advise that generating this vision requires all policies and strategies aligning towards a total change in focus that shifts care away from hospitals, and towards primary and community health care. Nurses are integral to the success of this system-based shift, so it is essential that the profession uses this opportunity to highlight their value in a new community-focused NHS.
Hospital-based data remains more sophisticated and available than the current data in community settings. Therefore, within this reawakened vision of health and care provision, there is an opportunity and call for nurses to articulate and support their value with worthwhile data, both qualitative and quantitative. Nurses have a unique area of expertise within complex community systems that, when recognised, can be developed as an established platform for collaborative and partnership work. Nurses who are active in research can detail this expertise alongside beneficial day-to-day community service and primary care data, to include waiting times, patient outcomes, and quality of care.
In a community-focused NHS, system leaders will require experience and expertise in primary and community-based health and care, in conjunction with the provision of education and training for practitioners and managers. Workforce planning, professional regulation, and pay and reward systems will need reviews to reflect this new context.
The refocus of health and care provision in the community supports people to live healthier lives in their communities where health and care needs are provided closer to home. It is essential to develop national responsibility by enabling communities to concentrate on meeting their local needs and peoples' individual circumstances as a strategic vision that, to be sustainable, necessitates a collaborative, efficient, and effective community-focused health and care system. If nurses find and articulate their voices to champion, support, and lead aspects of this change in focus, while working effectively within integrated multidisciplinary teams, they will be fundamental to this vision.