What shifting investment to community care means for home care - A Treasury review

In January 2026, the government signalled a major shift in how it will fund and organise health services.
On 20 January 2026, Pulse Today reported that the Treasury had launched a review to move investment away from hospital-centric care and towards primary and community services. This review forms part of a broader effort to redesign care so that people get help earlier, closer to home and in ways that are more integrated across primary care, community services and social care.
For HomeCareDirect, which champions personalised support at home, the review offers an opportunity to advocate for resources and policies that recognise the value of home-based care.

Why is a review needed?
The government’s announcement notes that healthcare has become overly centred on hospitals, while community, primary care, mental health, social care and local services have been left working in silos.
This fragmentation drives inefficiency and makes the system harder for patients to navigate. The review will examine how to test new funding flows and delivery models at selected sites.
In essence, ministers want to know how to ensure that money follows the patient out of the hospital and into community-based care without duplicating spending or adding bureaucracy.

The plan will be led by the Chief Secretary to the Treasury, James Murray, working with other secretaries of state.
Recommendations will inform the 2027 spending review and are intended to help root out wasteful duplication.
The Treasury has also launched parallel reviews into homelessness, youth services and management of public assets.

A second report by Healthcare Leader summarises similar points and quotes the Treasury acknowledging that, as healthcare became centred on hospitals, other services have been left working in silos, driving inefficiency.
It says the review will highlight these challenges and establish how to shift care back to communities sustainably across the NHS.
The review will be part of a wider set of public sector efficiency efforts, building on plans to deliver nearly £14 billion in technical efficiencies by 2028/29 and on additional savings announced at the Budget.
The review’s findings will also feed into the 2027 spending review.

What might change?
This review is connected to the 10-Year Plan for Health, published in mid-2025, which aims to move care from hospitals to local communities, prevent illness, and embrace digital technology.
Although the plan sets the direction, the details of how funding will shift are limited, prompting the Treasury to examine alternatives.
For HomeCareDirect, the shift could mean more resources being channelled to home care packages, assistive technology and community-based support teams, aligning with the government’s ambitions for a “neighbourhood health service.”

Dr Tom Dolphin, chair of the British Medical Association’s council, welcomed the principle of moving care into the community but emphasised that there are “many outstanding questions about the ‘how’”.
He warned that any shift must involve genuine new investment in general practice, mental health services and other underfunded areas.
Simply diverting money from hospitals risks overloading services that are already stretched; general practice in England currently receives only around 34p per patient per day.
Dolphin noted that rooting out inefficiencies is fine in principle, but it should not be used as an excuse to cut funding from hospital care.

Similarly, Professor Victoria Tzortziou Brown of the Royal College of General Practitioners said reforms must be supported by sustained investment and realistic planning.
Moving care out of hospitals must not simply transfer pressure from one part of the system to another; funding and resources must follow patients as they move into community settings. Professor Andy Brooks of the National Association of Primary Care argued that inefficiency rarely comes from duplication alone, but from fragmented decision-making and lack of shared accountability for populations.
For him, real efficiency requires enabling general practice and neighbourhood teams to take responsibility for defined populations, supporting people to stay well and preventing avoidable escalation.

What it means for home care
For providers like HomeCareDirect, a shift in funding towards community care could bring both opportunities and challenges.
On the positive side, new funding flows could enable local commissioners to invest in personalised home care packages that support the adoption of assistive technologies and expand the workforce that delivers personalised care.
This would align with HomeCareDirect’s model, which focuses on empowering individuals and their families to direct their own care, ensuring continuity and a Nurse-led, safe approach

However, as the BMA and others warn, these benefits will only materialise if the government commits real resources.
Without sustained investment, shifting activity without increasing capacity risks overburdening community services and reducing quality.
The review also raises questions about how social care and health budgets will interact.
Will there be integrated budgets that allow funds to flow seamlessly between the NHS and local authority services?
Will local authorities be given greater flexibility to commission creative home‑care models? How will the workforce, currently facing shortages in both health and social care, be supported?Staying engaged

The Treasury review is a reminder that the balance of healthcare provision is changing.
For people who use HomeCareDirect’s services and for families considering home care, it is important to stay informed.
The review’s recommendations, expected ahead of the 2027 spending round, could influence how much money flows into community-based services and whether personalised home care is properly valued.
HomeCareDirect will continue to advocate for policies that recognise the importance of choice, control and independence for those receiving care at home.
By keeping the focus on improving outcomes rather than simply cutting costs, the sector can help ensure that the shift from hospitals to communities leads to better health and well-being for all.