Community Health Services

Each year, community health services have about 100 million patient contacts and account for around £10 billion of the NHS budget and one-fifth of the total NHS workforce. This diverse sector covers a wide range of services, from those targeted at people living with complex health and care needs – such as district nursing and palliative care – to health promotion services – such as school nursing and health visiting. Community services play a key role in keeping people well, treating and managing acute illness and long-term conditions, and supporting people to live independently in their own homes.Community services are central to plans for the future of the health and care system. The NHS’s new long-term plan sets out ambitions to ‘boost “out-of-hospital” care, and finally dissolve the historic divide between primary and community health services’. It also committed to increasing the share of the NHS budget going to community and primary care services1, raising annual spending by £4.5 billion by 2023/4.

The ambition to deliver more and better health services in the community is not new. Throughout the history of the NHS, a series of policies have sought to strengthen and co-ordinate health services outside hospitals and to deliver ‘more care closer to home’.

But despite their vital contribution, community services are poorly understood compared to other parts of the NHS. In this explainer, we set out what these services are, the challenges they are facing and how they are changing.