Community services: What do we know about quality?

Care in community trusts was predominantly delivered by professionally qualified clinical staff such as community health nurses, allied health professionals and community health visitors. Staff numbers in the 18 trusts stayed roughly stable between late 2013 and 2016, although demand has almost certainly increased.

These staff were roughly as satisfied with their jobs as staff in all NHS trusts, although they were less likely to recommend their trust as a place to work.

The median waiting time for an outpatient appointment was three days longer in the community than across all trusts in England.

Patients using services offered by community trusts would generally recommend them to a friend and were less likely to experience harm compared to those using services provided by non-community trusts.

These quality measures gave us a much more limited picture of the quality of care in community services than anticipated. This is particularly concerning when policy continues to encourage the shift of more care into the community while far more remains to be understood. Ultimately, providers can only effectively manage what they can measure, so if moves to improve national quality measures in community services fall short, we will continue to ‘fly blind’ on the care received by millions of patients every year.