Ageing populations and the rise of multi-morbidity are straining already overburdened healthcare systems, while the supply of healthcare professionals struggles to keep pace. In response, there is growing momentum to shift care delivery from hospital settings to community environments. This strategic shift not only promises to reduce pressures on secondary care but also aligns with evolving patient expectations of personalised, accessible and digitally enhanced services. However, making this transition a reality presents a range of operational, cultural and technological challenges that must be addressed for care closer to home to be both effective and equitable.
Evolving Demand and the Push for Community-Based Models
Healthcare systems are under sustained pressure from both demand and supply sides. On one hand, an ageing population with multiple chronic conditions contributes to a rise in complex care needs, often requiring coordinated management across various specialties. On the other hand, healthcare staff shortages create service gaps and limit the system’s capacity to respond efficiently. Adding to this challenge is a shift in patient behaviour. Individuals increasingly see themselves as consumers, accustomed to the immediacy and personalisation of services in other industries. These patients expect healthcare to mirror digital convenience and responsiveness. This consumerisation not only alters the patient-provider dynamic but also demands a transformation in how and where care is delivered. Delivering healthcare in community settings or at home has emerged as a strategic solution to these pressures, promising reduced waiting times, more responsive care and, ultimately, a more sustainable model.
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Addressing the Barriers to Shifting Care Closer to Home
Transitioning to community-based care requires significant structural and cultural changes. One of the primary challenges is managing the needs of patients with multiple long-term conditions outside of hospital environments. This demands enhanced coordination, tailored patient information and robust support mechanisms. Empowering patients is equally critical; they must be equipped with the knowledge and tools to manage their health. Clear, accessible information and user-friendly self-management resources can foster greater autonomy, particularly for those with varying levels of health literacy.
Access remains another major hurdle. Certain groups face disproportionate barriers due to location, language, transport and service availability. To address these disparities, initiatives such as digitally enabled care pathways and targeted inclusion programmes have been introduced. Equally, the technological backbone required to support this shift must be both flexible and inclusive. Interoperable platforms are needed to connect hospitals, primary care and community services while ensuring that digital solutions do not exclude those with limited technical skills or access. Alongside these efforts, securing data privacy and making patient-generated data actionable are fundamental to maintaining trust and delivering quality care.
Building Capacity through Technology and Workforce Transformation
The successful shift to home-based care models relies heavily on the adoption and integration of appropriate technologies. Digital tools must support a wide range of clinical needs and treatment pathways while being adaptable to local conditions. Inclusion must be prioritised to ensure that language barriers and low digital literacy do not widen existing health inequalities. Beyond the tools themselves, the meaningful use of data—particularly from remote monitoring and patient-reported outcomes—can enhance clinical decision-making and population health management. However, this necessitates investment in infrastructure and data analytics capabilities.
In parallel, the healthcare workforce must evolve to meet the demands of this new model. Professionals need training not only in digital tools but also in delivering care across varied settings. Collaborative models involving hospital specialists, general practitioners and community health teams are essential. Addressing staffing shortages in community settings and developing new roles tailored to this decentralised approach will also be crucial. Empowering the workforce with skills and resources ensures that care delivery remains consistent, coordinated and patient-centred, regardless of location.
With rising demand and limited capacity of healthcare services, shifting care closer to home offers a promising path toward sustainability and improved outcomes. Yet, realising this shift requires more than policy declarations. It calls for a fundamental redesign of care delivery—one that places patients at the centre, builds inclusive digital infrastructure, fosters new workforce capabilities and addresses systemic inequalities. By tackling these interconnected challenges head-on, healthcare providers and policymakers can build resilient systems capable of delivering high-quality, accessible care where patients need it most.
Source: Healthcare Transformers
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