While COVID-19 has accelerated collaboration between primary and community care in some parts of the country, other areas will need more support to recover from the impacts of the pandemic and time to work through competing pressures. The marked expansion in the use of digital technology, remote monitoring and virtual consultations during the pandemic will need to be embedded into 'normal' service delivery where it continues to work best for patients and staff. PCNs will soon need to turn their attention to the DES service specifications due for implementation in October 2020.
As NHS England and Improvement re-establishes its system-by-default operating model, neighbourhood-level integration will likely play a key role in addressing health inequalities exacerbated by COVID-19 and accelerating population health management. Primary and community care will need to be well-represented in strategic decision-making on the restoration of services at system level. The system architecture needs to facilitate the right behaviours and good relationships, supported by resources moving around the system in the right way and contractual mechanisms that do not hold back transformation nor restrict different models of care.
NHS community health services have a clear vision of high-quality joined-up care in the community, supported by 'home first' discharge pathways, increased investment and flexible workforce models with their partners including primary care. To achieve this vision of more care delivered in the community, national prioritisation and funding – both capital and revenue – are essential to ensure that the NHS resets to a new and improved normal.