Community Hospitals

Helen Maguire Excerpts

Tuesday 16th June 2026 Westminster Hall

[Helen Maguire (Epsom and Ewell) (LD)]

It is a pleasure to serve under your chairship, Sir Jeremy. I thank my hon. Friend the Member for South Cotswolds (Dr Savage) for securing this important debate on community hospitals.

Community hospitals have been a core part of our healthcare system for more than 150 years. They are rooted in a strong tradition of providing care and a range of clinical services to support their local populations. There are over 500 community hospitals throughout the UK, and they vary considerably in the services they deliver as their fundamental focus is to adapt to ensure that they serve the needs of their local area.

Community hospitals serve as multidisciplinary sites for immediate care across both health and social care, bridging the gap between primary and secondary care services. This adaptation and integration of services in particular makes community hospitals so valuable in bringing vital health services into the community and truly serving the specific needs of the community they represent, whether they have a significant older population or are situated in an area of high deprivation.

The value of community hospitals cannot be overstated, as we have heard today. They are ideally placed to support effective prevention and the management of long-term conditions. They have the ability to be flexible, change and adapt with their population. By reimagining what we can do with community hospitals, based around the needs of an ageing population and rising complexity, we can make a significant difference to patients.

I have seen the benefits of community hospitals at first hand in my constituency of Epsom and Ewell. Leatherhead community hospital, which is highly valued by the local community, demonstrates the importance of maintaining strong accessibility, continuity of care and patient flows across community health infrastructure. Leatherhead community hospital provides more than 33 specific consultation and out-patient services, including a stoma clinic, physiotherapy rehab, and speech and language therapy, for the diverse population it serves. We must support community hospitals to ensure they can continue to provide such services.

Community hospitals also play a core role in reducing the pressures on larger acute hospitals. Their role will only continue to grow in importance as demand on NHS services continues to rise. Community hospitals support earlier discharge and step-down care to patients who are medically fit to leave acute hospitals, but still need further support to regain their independence prior to being fully discharged.

The Health Foundation estimates that, in England, about 125,000 people enter intermediate care services each month. The cost of providing this care continues to rise, increasing the pressure on these underfunded services. The average local authority spend on a single episode of care in 2022-23 was 27% higher in real terms than in 2019-20.

Community hospitals provide intermediate care beds, so they free up hospital beds, reducing the high demand on A&E departments. That intermediate support is particularly important in rural and coastal areas where, as we have heard today, access to acute hospitals is often limited.

In 2021, the chief medical officer’s annual report on health in coastal communities provided official recognition of the range of healthcare needs across different rural communities. Those living furthest from healthcare services in rural and coastal areas are most at risk of experiencing inequalities, particularly when there are poor and unaffordable transport connections—not to mention the patients who, due to old age or disability, are unable to drive long distances to access essential healthcare.

It takes twice as long for people in rural areas to reach their nearest GP by public transport as it takes people in urban areas; it also takes about a third longer for those who drive, according to the Rural Services Network. Those findings were affirmed by Lord Darzi’s report on the NHS, which found that across much of rural England—including nearly the whole south-west as well as much of the east of the country—there are fewer than 46 dentists per 100,000 people.

A Liberal Democrat freedom of information request found that waiting times for life-threatening calls are 45% longer in rural areas than in urban areas. Community hospitals, like rural GPs, pharmacies and other healthcare services, have frequently been an afterthought. That situation is unacceptable: we must take action to change it, particularly given that the Government say they want to move services into the community. Access to vital community healthcare cannot be dictated by an unjust postcode lottery.

Community hospitals receive less funding and less attention than larger acute hospitals, resulting in workforce shortages and rundown estates. There has also been an escalating process of service reductions at many community hospitals. Often, these changes are introduced under the guise of being trials, but they almost always become permanent. Pragmatic changes to services because of shifting demand are sometimes necessary, but too often changes are made without proper consultation or a proper explanation to the communities affected.

The Liberal Democrats are clear that we wholeheartedly support the ambition to shift more care into the community, but we must get community hospitals to a place where they can complement and play a vital role alongside neighbourhood health centres. Rural communities know all too well the pressure that the healthcare system in their areas is under, and the important role that community hospitals play. Consequently, we have been calling for a rescue plan for rural health services, in which rural community hospitals would be an essential pillar.

As part of the plan, we have called for a strategic small surgeries fund to sustain services in rural and remote areas, as well as a strategy to close the gap in access to primary healthcare between urban and rural areas. We are also calling for an emergency fund to reverse closures of community ambulance stations and to cancel planned closures of services where they are needed, which would particularly benefit rural communities. We would put an end to the postcode lottery of care provision, which disproportionately impacts rural communities, through a national care agency. We need a new national drive for first responders in rural communities. We need to protect air ambulances, integrating them into the emergency care system, and to ensure that they receive adequate NHS funding in addition to charitable donations.

Will the Minister heed these calls and take the necessary steps to ensure that community hospitals that serve rural communities receive the support they deserve? The bottom line is that community hospitals are a service to us all. They are vital in the provision of care closer to home; they bring multidisciplinary services closer to the community; they bridge the gap between hospitals and GPs; they relieve strain on hospital beds and A&E departments; they support faster discharge and rehabilitation, and so help patients to regain their independence; and they improve healthcare access for elderly and vulnerable patients by reducing travel burdens for both themselves and their families.

I urge the Minister to reflect on the important calls that I, my hon. Friends and others across the House have made in this debate, to ensure that we are all doing all we can to better support community hospitals.

--- Later in debate ---

[Mrs Hodgson]

As the hon. Gentleman has acknowledged, this is not actually my brief. As much as I can try to answer his questions, I think I might have to commit that the relevant Minister will write to him on that specific point.

For patients who still require hospital care, we are delivering millions of additional appointments and reducing waiting lists across elective care. The Government’s elective reform plan sets out commitments to reduce disparities across elective care access and waiting times, including by improving practical support for patients through better transport options. Virtual care models will offer patients in remote areas better access and more convenience by providing services that are more responsive to their needs. Expanding digital access is also crucial to improving the experience and health outcomes for rural communities. Digital services can improve access for many patients, but they must complement, not replace, high-quality, local face-to-face care.

[Helen Maguire]

I want to expand on that point because, as we have heard from Members, there are many elderly people in rural communities who may or may not have access to digital services. Will the Minister provide some assurances to me and my hon. Friends that elderly people will not be excluded because they cannot access services digitally?

[Mrs Hodgson]

Absolutely. Digital services will complement and not replace the face-to-face care, so we are developing the NHS app and expanding online consultations for those for whom it will be helpful. There will be digital triage and remote monitoring, allowing patients in rural areas to access more NHS services, but I take on board the hon. Lady’s point about ensuring that we do not exclude people.

It is important to recognise that decisions about individual services are made locally by NHS organisations, which are responsible for assessing the needs of their populations and planning services accordingly. As strategic commissioners, ICBs work closely with health and wellbeing boards, local authorities and other partners to identify the most impactful outcomes for their population. ICBs will choose the right delivery model for their local area to deliver these outcomes, enabling capable providers to lead local services designed to meet the needs of their patients. That means looking carefully at local need, rurality, the workforce, clinical evidence and the long-term sustainability of services, rather than applying a one-size-fits-all model. Those decisions must be accompanied by appropriate engagement with patients, staff and local communities.

The hon. Member for South Cotswolds highlighted an important challenge. Whether national ambitions are matched by what people say and experience on the ground is a question we must take seriously. If we are to successfully shift care closer to home, community-based services must be equipped to meet growing demand. In Cirencester, as we have heard, local provision remains very important. Existing services continue at the hon. Member’s local hospital, including in-patient and out-patient care, therapies and the minor injury and illness unit. Local NHS partners are also testing how services can better meet local need, including a specialist 15-bed frailty complex care unit alongside a 28-bed intermediate care ward. These changes are being tested locally and evaluated carefully; I am told that no permanent decisions have been made.

I have made a careful note of the hon. Member’s five questions, as I am sure my officials have. I will ensure that the relevant Minister writes to her with further details on her specific questions; I will also request that they meet her, as her fifth request was about when that could be arranged. On staffing in particular, I can update her: the NHS workforce plan is to be published imminently.

The pressures that hon. Members have described are familiar across much of the country. We have an ageing population, an increasing prevalence of long-term conditions, growing demand for rehabilitation and recovery services and, in some areas, significant population growth driven by new housing developments. These pressures make local community-based services more important, not less. Meeting those challenges will require strong, joined-up community services, with community nursing, therapies, rehabilitation, urgent community response, virtual wards, and primary care and social care working together across the needs of patients.

Ultimately, the future of community hospitals should not be considered in isolation. They form part of a broader community heath infrastructure that includes neighbourhood teams, community providers, primary care, mental health services, social care and the voluntary sector. The question is not simply how many community hospitals we have, but how we use our community assets and services to provide high-quality care closer to home.

I am very grateful to the hon. Member for South Cotswolds for bringing this important issue before the House. The debate has highlighted both the enduring value of community hospitals and the important role that they can play in supporting local populations, especially rural ones. As we continue our work to strengthen neighbourhood health services and shift care closer to home, the experiences and concerns raised by hon. Members today will make an important contribution to that discussion. I thank all hon. Members for their participation in this debate.