From hospital to community: International lessons on moving care closer to home

In July 2025, the government launched its 10 Year Health Plan for the NHS in England, with a central aim of shifting more care from hospitals into community settings. This ambition is not new: successive initiatives over decades have sought to strengthen out-of-hospital care, but most have fallen short of expectations.

England is not alone in grappling with this challenge, and other countries have pursued similar reforms. This report examines, in depth, the experiences of Denmark and Ireland, distilling lessons that can inform England’s efforts to deliver its new health plan.

We focus on these countries because both have committed to bold, long-term strategies to rebalance care towards communities, reduce pressure on hospitals, and respond to ageing populations and rising chronic disease. Denmark is just at the start of its reform, whereas Ireland is nearly a decade in. Their contrasting trajectories and contexts highlight both common challenges and practical approaches that England can learn from.

Our findings draw on 24 expert interviews and a structured review of policy documents and literature from Denmark and Ireland. Aimed at system leaders, policy-makers and government, it distils lessons from these countries’ reform efforts to inform England’s delivery of the NHS 10 Year Health Plan. 

Read the full report and lessons