Hospital to Community

The 10 Year Health Plan for England sets out a bold and ambitious new direction for the NHS, aiming to make care more accessible, personalised and responsive to everyday life.

This transformation is already taking shape across our region. Community Diagnostic Centres, virtual wards, Urgent Community Response teams and integrated neighbourhood health centres are shifting care out of hospitals and into communities. These changes are helping people access timely, joined-up support while easing pressure on emergency and acute services.

Neighbourhood Health Teams bring together GPs, nurses, pharmacists, therapists and social care professionals to deliver extended-hours care that meets local needs.

Explore how services across the North East and Yorkshire are evolving to improve outcomes, support families and strengthen care in the places people live.

▼ NHS Community Diagnostic Centres

 

Across the North East and Yorkshire, NHS Community Diagnostic Centres (CDCs) are transforming how and where people access vital health tests, scans and checks — supporting a key ambition of the NHS 10 Year Health Plan to shift more care from hospitals into the community. Whether it’s an MRI or CT scan, an ultrasound or a routine blood test, these centres offer quicker access to the same high-quality diagnostics you’d find in hospital but in more convenient, community-based settings.

With more than 30 centres now open in accessible locations like town centres, retail parks and shopping centres, CDCs are helping to reduce waiting times, speed up diagnoses and support earlier treatment. Millions of procedures have already been delivered across the region, with more centres opening soon.

By moving diagnostics closer to where people live, CDCs are not only improving early detection and supporting the NHS Elective Recovery Plan — they’re also a clear example of how care is being rebalanced towards local, accessible services in line with the NHS’s long-term vision for more personalised and preventative healthcare.

▼ Barnsley’s Trailblazing Health on the High Street Initiative

 

Barnsley’s Health on the High Street initiative is a bold step in moving care from hospitals to communities. The transformation of the Alhambra Shopping Centre into a modern health and wellbeing hub will bring outpatient services, mental health support, and lifestyle services right into the town centre — making care more accessible, integrated, and convenient for local residents. This next phase builds on the success of the Community Diagnostic Centre at The Glass Works, which has already delivered faster diagnoses, improved attendance rates, and boosted footfall. By reimagining how and where care is delivered, Barnsley is showing what the future of community-based healthcare can look like.

▼ Neighbourhood Mental Health Hub Pilots

 

Three of the NHS’s six national mental health hub pilots are based in the North East and Yorkshire — in York, Whitehaven and Sheffield. These new hubs are designed to offer 24/7, walk-in access to mental health support in the community, including integrated crisis teams, early intervention, and short-stay alternatives to hospital.

They’re part of a wider shift set out in the upcoming 10 Year Health Plan — moving more care out of hospitals and into local settings, so people can get the right support earlier, closer to home.

Find out more about how new community mental health hubs in our region are helping shift care closer to home and supporting the ambitions of the NHS 10 Year Health Plan.

▼ Airedale: Urgent Community Response service

 

Airedale NHS Foundation Trust’s Urgent Community Response (UCR) Service provides rapid, 24/7 care to help adults stay well at home and avoid unnecessary hospital admissions. Operating across Airedale, the multidisciplinary team responds within two hours of referral and includes nurses, therapists, mental health workers, and other professionals.

Between 2024 and 2025, the team handled over 1,000 referrals, with 88% of patients remaining safely at home. Referrals come from GPs, ambulance crews, community teams, and hospital departments when patients are safe to stay at home but need urgent support.

The service typically supports people with acute illness, falls without injury, reduced mobility or confusion, palliative care needs, or urgent equipment requirements — often resolving multiple issues in a single visit.

▼ Jean Bishop Integrated Care Centre  

As part of the NHS 10 Year Health Plan to deliver more personalised, convenient care closer to home, centres like the Jean Bishop Integrated Care Centre in Hull are transforming how we support older people and those living with frailty. By bringing together GPs, community nurses, therapists, social care and voluntary services under one roof, these centres provide joined-up assessments and wraparound care that help people stay well in the community. It’s a powerful example of the shift from hospital-based treatment to proactive, person-focused support in neighbourhood settings.

▼ Scunthorpe MSK Community Project  

Since June 2024, nearly 400 local residents suffering from musculoskeletal (MSK) problems—such as bad backs, shoulder pain, and knee or ankle issues—have benefited from a pioneering Community Appointment Day (CAD) programme at Scunthorpe General Hospital.

Led by a dedicated team of 16 MSK physiotherapists and supported by administrative staff, the initiative has reduced the longest wait times for appointments from 26 weeks to just over five weeks in only four months. Crucially, non-attendance rates have halved, and nearly a quarter of attendees receive on-the-spot pain-management advice. Around 20% are also joining healthy-lifestyle schemes such as gym inductions and community fitness sessions. 

▼ Paramedics working with communities to provide out-of-hospital care  

Across the North East, North East Ambulance Service is delivering essential care in patients’ homes, helping to reduce avoidable hospital admissions and easing pressure on local NHS services.

Working in partnership with GP practices, district nurses and other community teams, these paramedics support elderly and vulnerable patients, including those receiving end-of-life care. They provide timely clinical treatment, continuity of care and a trusted, familiar presence in the community.

This joined-up approach reflects the hospital to community shift set out in the NHS 10 Year Health Plan. By supporting more patients at home, the service improves outcomes, promotes independence and ensures people receive the right care, in the right place, at the right time.

▼ Pharmacy First  

Pharmacists and patients in the North East and Yorkshire have welcomed the benefits of Pharmacy First, which includes enabling people to receive treatment from high street pharmacies for seven common conditions, minor illnesses, and urgent medicine supply, without needing to see a GP. Since January last year, patients in England have been able to get treatment and medicines from their local pharmacy for sinusitis, sore throat, earache, infected insect bite, impetigo, shingles, and uncomplicated urinary tract infection.

In episode three of the Transforming Primary Care podcast, we focus on NHS community pharmacy services – exploring the benefits for both practices and patients, and how these services support the wider shift from hospital to community-based care set out in the NHS’s 10-year plan. Hear how pharmacies are helping to ease pressure on GPs, improve access to care, and what the future could hold.
🎧 Listen now: Transforming Primary Care podcast

▼ Bringing Care Closer to Home: Northumbria Healthcare  

Northumbria Healthcare NHS Foundation Trust’s virtual ward is a leading example of how the NHS is safely shifting more care into the community. By providing hospital-level treatment and monitoring in people’s homes, the virtual ward supports patients with conditions such as respiratory illness, frailty, or heart failure to recover where they feel most comfortable. This approach not only helps to prevent unnecessary hospital admissions and speed up safe discharges, but also frees up beds for those who need them most. The service is backed by specialist clinical oversight and delivered by a dedicated team working closely with existing community services. It’s a clear demonstration of the NHS’s commitment to modern, patient-centred care outside traditional hospital settings.

▼ North Tees & Hartlepool: Helping patients stay where they’re happiest — at home

 

The virtual frailty ward at North Tees and Hartlepool is transforming how we care for people with frailty or long-term conditions — bringing hospital-level care into the home and helping to reduce avoidable admissions. Delivered as part of the NHS Hospital at Home model, the service offers timely, tailored care including IV antibiotics, medication reviews and help with daily living. Patients benefit from being treated in familiar surroundings, while families gain reassurance and continuity of care.

This approach supports the shift outlined in the NHS 10 Year Health Plan, moving care out of hospitals and closer to where people live. By supporting people to stay well at home, the virtual frailty ward is improving outcomes, easing pressure on acute services and ensuring care is more personalised, proactive and joined-up.

▼ Leeds: Home‑First Rehabilitation, Reablement & Recovery Dashboard

 

Leeds’ innovative Home‑First programme is driving the NHS vision of delivering care closer to home by ensuring rehabilitation, reablement and recovery services are coordinated and delivered in community settings wherever possible. Supporting more than 3,000 residents, this initiative brings together short‑term community therapy, enhanced care at home, and step‑down recovery beds through integrated neighbourhood teams. Central to its success is a system‑wide reporting suite and a shared analytics dashboard, trusted by all partners, which provides a unified view of patient flow and supports real‑time decision‑making. This collaborative, data‑driven model not only helps avoid unnecessary hospital stays—but also embodies the NHS 10 Year Health Plan’s commitment to shifting care out of acute settings and into communities where people live and recover.

▼ Enhancing community health in Gateshead

 

Across Gateshead, health and care providers work closely to improve access and join up care for our communities. We want to shift the balance of services from acute hospital care and crisis interventions to community support with a focus on prevention, early help and self-help.

One of these organisations is CBC (Community Based Care) Federation. CBC helps to bring essential NHS services directly into the heart of the community. Offering a range of health provisions at convenient locations and times, including evenings and weekends ensures that residents can access the care they need, when they need it.

One prime example is at the Bede Centre in Felling, Gateshead. This hub provides a diverse array of services, significantly easing the burden on traditional GP surgeries and emergency departments while making healthcare more flexible for patients.

Services offered at the Bede Centre:

  • Coil and implant fittings and removal and cervical screening (smear tests): These vital services are readily available for patients registered with a Gateshead GP, with appointments seamlessly booked through their GP practice. This streamlined process ensures easy access to essential reproductive health services.
  • COVID-19 booster clinics: The Bede Centre offers convenient walk-in appointments for COVID-19 vaccinations and boosters, playing a crucial role in the ongoing public health effort.
  • Acute respiratory infection clinics: Providing specialised care for conditions such as asthma, COPD, and other respiratory issues, these clinics offer dedicated support to patients managing chronic and acute respiratory problems.
  • Spirometry: The CBC Health Federation conducts comprehensive respiratory assessments and tests, aiding in the diagnosis and management of respiratory conditions.
  • “Enhanced Access” primary care appointments: This critical service offers urgent, same-day primary care appointments. By addressing immediate health needs, these appointments effectively reduce pressure on GP surgeries and emergency departments, ensuring patients receive timely care in a more appropriate setting.

Providing these services during the day as well as evenings and weekends, supports flexible healthcare access. This model not only brings healthcare closer to home but also empowers individuals to prioritise their health without compromising their daily commitments.

Nimbus Care – Improved triage and navigation, York Community Frailty Hub  

A community-based approach to healthcare in York is helping to prevent unnecessary hospital admissions. The York Community Frailty Hub was established in November 2023, to address the fragmented support for frail people in the community by bringing together elements of General Practice, the Acute Trust, Local Authority, adult Social Care, Community Services, Ambulance Service and Voluntary sectors into one coordinated system.

The service is made up of 3 key parts: a frailty prevention team, a discharge support team, and a frailty crisis response team. The crisis response team helps reduce avoidable hospital admissions through a dedicated advice and guidance line and rapid multidisciplinary community response. In 84% of cases, the York Community Frailty Hub has helped paramedics avoid hospital transfers by providing advice after an ambulance is dispatched, enabling patients to be safely supported in the Community. The Hub also serves as an alternative to calling 999, offering early advice to frail residents, families, carers, and health professionals, and working collaboratively to determine the best course of action to keep people safely at home.

▼ Primary care at greater scale in Sheffield  

Primary Care Sheffield (PCS) is a social purpose organisation rooted in general practice and the values of the NHS, founded by the city’s GPs. It delivers support to its membership – the 69 GP Partnerships and 16 PCNs in the city – whilst also directly managing a further 9 GP surgeries. Through its 442 staff, it delivers a range of services to a population of 600,000 residents of Sheffield, many deployed at a neighbourhood level, from diagnostics (24-hour ECGs, tele-dermatology), health checks, R&D, training & development and support for primary care estates.

The scale of PCS offers significant resilience to the GP practices in the city – supporting them to thrive, providing support to those struggling, and occasionally taking them under their management when needed. As importantly, it also creates capacity – for example, through an urgent home visiting service, or by flexing capacity across practices during busy winter and bank holiday periods. During the winter of 2023/4, one of the highest periods of demand for the NHS on record, PCS provided over 12,000 additional respiratory illness appointments, and a further 15,000 additional appointments for children. PCS also supports the wider healthcare system, with evidence of lower hospital use, better take up of contraceptive services and significant extra care capacity for patients with severe mental illness.

This shift will continue to grow, with Neighbourhood Health Centres opening in every community and more services delivered through pharmacies, dental practices and high street locations. Over time, patients will increasingly receive diagnostics, rehabilitation, mental health care and post-operative support without needing to visit hospital.

By 2035, most outpatient care will take place in the community. This change will be supported by better digital tools, shared care records and personalised care planning, including a target for 95% of people with complex needs to have a care plan in place by 2027.