Service inspections: independent community health services

These include health services for adults provided in their homes or in a community-based setting. They often focus on providing planned care, rehabilitation following illness or injury, ongoing and intensive management of long-term conditions, coordinating and managing care for people with multiple or complex needs, and health promotion.

This includes:

• community nursing services or integrated care teams, including district nursing, community matrons and specialist nursing services
• community therapy services such as occupational therapy and physiotherapy
• community intermediate care
• community rehabilitation or reablement services
• community outpatient and diagnostic services

This does not include:

• community end of life care for adults (inspected as part of community end of life care)
• primary medical or dental care, urgent care services, community learning disability or mental health services (inspected as part of other additional services or relevant services for other sectors; for example, inspections of mental health services include community mental health services for people with a learning disability or autism)

This includes health services for babies, children, young people and their families in their homes, community clinics or schools. It includes universal health services and health promotion (such as health visiting and school nursing) and delivering and coordinating specialist or enhanced care and treatment including specialist nursing services, therapy services and community paediatric services. These services provide and coordinate care and treatment for children and young people with long-term conditions, disabilities, multiple or complex needs and children and families in vulnerable circumstances.

This service can also include community sexual health services for people of all ages and community dental services for people of all ages where they are not covered as an additional service.

This does not include:

• child and adolescent mental health services (included in the mental health CAMHS service)
• community end of life care for children and young people (included in the community end of life care service)
• community midwifery services (included in the acute maternity service)
• social care for children and young people (regulated by Ofsted)

This includes all inpatient and day-case wards in community hospitals for people of all ages.

Examples of the care provided include:

• inpatient rehabilitation
• inpatient intermediate care
• inpatient nursing and medical care for people with long-term conditions, progressive or life-limiting conditions or for people who are old or frail
• minor surgical procedures

This service does not include:

• other community health services that the provider runs from a community hospital site, such as community nursing or therapy clinics or outpatient services (included in community health services for adults and/or for children, young people and families)
• end of life care provided to people on community inpatient wards (covered under community end of life care)
• any services that are run from the location but provided by other providers, such as walk-in centres

This includes all end of life care for adults, young people and children that is provided in people’s homes and in community hospitals, whether provided by specialist palliative care or hospice at home teams or as part of other services such as district or community nursing. This service also includes services in a hospice setting where they are run by a provider with a range of community health services.

Where a provider reports a very small number of deaths, we may decide to report end of life care under the most relevant service, usually community health services for adults.

Services covered by this service include:

• STI screening, diagnosis, treatment and prevention
• contraception services, including emergency contraception
• other genitourinary services
• specialist HIV testing, treatment and care services
• health promotion and healthy relationship advice
• psychosexual medicine and counselling
• contact tracing/partner notification for sexual partners at risk of STI

Community dental services are all commissioned by NHS England Area Teams to provide a wide range of care not provided by primary care dental services. These services include:

• a full range of treatment services to patients with special needs (both adults and children)
• a referral service for other health and social care practitioners
• dental care for patients who would have difficulties accessing ordinary primary care dentistry
• specialist services, for example special care dentistry, paediatric dentistry and orthodontics
• general anaesthetic and sedation services
• access services, for example out-of-hours services, domiciliary care and Dental Access Centres (DACs)
• public health, including screening, health promotion and epidemiology
• access for groups of people who may be vulnerable

These are community facilities delivering care that can be accessed without a referral, in an urgent or emergency situation. The purpose of urgent care is to treat patients presenting as an emergency or with urgent medical needs. Services include urgent care centres (UCCs), minor injuries units (MIUs) and walk-in centres.