Title: Advancing community hospitals and services in the NHS: learning from international experiences
Funder: Department of Health (England)

Abstract: Community hospitals form an established component of healthcare provision in England but there is potential for them and related service delivery models to assume a more strategic role in local health economies particularly in meeting the health and social care needs of future populations. The proposed research seeks to: (1) review the existing evidence base on community hospitals and equivalent service delivery models nationally and internationally examining a range of organisational characteristics as well as outcomes; and (2) draw on experiences in other countries on the contribution of community hospitals to the healthcare system by assessing equivalent service delivery models. Specifically we seek to understand (1) the nature and scope of service provision models that can be considered under the umbrella term ‘community hospital’ in the UK and other high income countries; (2) the evidence of effectiveness and efficiency of community hospitals and comparable service models in the UK and other high income countries; (3) the wider role and impact of community engagement in community hospital service development and provision; (4) how models that are comparable to community hospitals in England operate and their role within the wider system of service provision in other countries; and (5) the potential for such models to perform an integrative role on the delivery of health and social care in other countries. Evidence synthesis of community hospitals in the UK and other high income countries: We propose undertaking a comprehensive scoping review to understand how community hospital have been conceptualised and defined in the United Kingdom and other high income counties. We will seek to identify the range of organisational models of service delivery that can be broadly subsumed under the heading of a community hospital and what is already known about service provision and their role in the local and wider healthcare economy. Learning from international experience: We will conduct five country reviews to gain a detailed understanding of the nature scope and distribution of service delivery models that can be considered comparable to community hospitals in England. This will be achieved using: (i) a structured data collection template reviewed and validated by an expert in each country and (ii) 8-10 key informant interviews. We will then undertake detailed case studies of community hospital models in a small subset of countries to provide in-depth understanding of particular models that appear innovative and to offer learning to service development in England. The case studies will follow a structured approach and include a local stakeholder mapping document review population assessment interviews and non-participant observation. We will synthesise the evidence and compare and contrast our findings with those of the two complementary studies of community hospitals submitted under this call which we will use to draw lessons for future strategic planning of health and social care services in England. We believe that this research will provide important insights for clinical commissioning groups into the potential role of community hospitals in the future delivery of health services closer to home.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE