Our strategy: Outstanding care, healthier communities 2026-2031
Welcome
Foreword – Chair and Chief Executive
We are at a defining moment for community healthcare. The NHS 10-year plan has put community services at the heart of the health system's future – recognising what we know to be true: that care delivered closer to home produces better outcomes, better experiences, and better value. The strategic shift from hospitals to communities – the 'left shift' – isn't just policy aspiration; it's the fundamental transformation of our health system. This strategy sets out how we will seize this opportunity for the benefit of our patients, working with partners, grounding ourselves in the communities we serve and pioneering new models of care, to deliver the care that our communities need.
As a specialist community provider, we occupy a unique and powerful position. We are invited into people's homes at life's most significant moments – caring for new babies, supporting families managing illness, guiding people through recovery, and providing compassionate care at the end of life. We work with children, young people, adults and older people, supporting health and wellbeing across entire lifetimes. This privileged access gives us unparalleled insight into what our communities truly need, and the opportunity to make a real difference.
But we cannot do this alone, and nor should we. This strategy is as much a commitment to partnership as it is a plan for Hertfordshire Community NHS Trust (HCT). We want to work with you – our colleagues in primary care, health and care partners, local authorities, education providers, voluntary and community organisations – to coordinate services around people, not organisational boundaries. Together, we can deliver the seamless, prevention-focused care that will meet rising demand sustainably whilst improving outcomes and experiences.
We are committed to acting on health inequalities. The 13-year gap in life expectancy across Hertfordshire is unacceptable, and we know that certain communities face persistent barriers to good health. We will be outwards-looking and sensitive to these needs, actively seeking out and listening to those who are seldom-heard or often ignored, and designing services that work for everyone.
None of this would be possible without our staff – our greatest asset. We are immensely proud of our culture: caring and inclusive, and at the same time pioneering in our ambition to try new things and continuously improve. Our staff survey results place us among the very best NHS organisations to work for, but we will not rest on these achievements. We will continue investing in our people, supporting their wellbeing and developing their skills, and empowering them to innovate and lead change.
We have the energy, the passion, and the commitment to deliver this strategy. Over the next five years, we will pioneer new models of care, harness technology and data, embed prevention in everything we do, and work as true partners across our system. We will seek excellence in health outcomes whilst remaining firmly rooted in the communities we are privileged to serve.
This is our pledge to the people of Hertfordshire and the East of England: we will provide the very best care we can, when and where you need it most.
Who we are and what we do
The population we serve
Since 2010 when Hertfordshire Community NHS Trust, or HCT as we are commonly called, was established, we have been rooted in Hertfordshire, serving communities across East and North Hertfordshire and South and West Hertfordshire. Across this area we deliver a wide range of community health services, working with partners to ensure that the 1.2 million residents have the care and support they need.
Over the last five years our reach has grown significantly, for example we now also deliver School Aged Immunisation Services and Child Health Information Services across the entire East of England (figure 1), with a population of 6.5 million, our services playing a vital role in preventing ill health and ensuring vulnerable children and young people do not slip through the net.
We are committed to reducing health inequalities and we know that geography, deprivation and other factors can create barriers to good health. Our presence across this wider region means we can reach more people who need us most, bringing high-quality community care closer to home.

Figure 1. NHS East of England region showing ICB boundaries (adapted from NHS Confederation).
Our population and its health
Whilst we provide services across the entire East of England area, most of our services are in Hertfordshire. Hertfordshire is often described as 'an affluent county with pockets of deprivation' – but this simple phrase masks a complex reality. Behind the statistics are diverse communities with very different experiences of health and healthcare.
We see this diversity every day. Our staff work in busy and thriving towns, remote rural villages, coastal areas, and in many of these areas families face significant challenges. They support people from different cultural backgrounds, with different languages, different health beliefs, and with varying levels of trust in health services.
Understanding this diversity is essential to our work; we cannot assume that a service designed for one community will work for another. Instead, we actively listen, adapt our approach, and work to reach those who might otherwise be left behind. This means tailoring how we communicate, where we deliver care, and how we make it easy for everyone to access the support they need.
The Hertfordshire population and its health
- 6% of the population have diabetes
- 14% of the population has a cardiovascular disease
- 6.25% of the population are living with frailty, most of who will have at least two long-term conditions
- 20% of year 6 students are obese, a trend that has consistently been rising over the last 15 years
- Consistent increase in pupils diagnosed with special educational needs (SEN), expected to reach 20% by 2030
- Higher percentage of 0-4 year olds attending A&E than regional and national averages
- Total population has grown by 8% since the 2011 census
- Our population is getting older. 16% are over the age of 65 now, expected to increase to 24% by 2040
- 14 of 690 areas in Hertfordshire are in the most deprived 20% of areas in the country. 279 areas are in the 20% least deprived
- Life expectancy is 83 years — higher than the national average
- Healthy life expectancy ranges from 56.9-75.5 years
- Hertfordshire is becoming more diverse. In 202128.2% of residents identified themselves as being from an ethnic minority, compared with 19% in 2011.
Our Trust in numbers
- 842,000 contacts with adults per year,
- 405,000 children and young people contacts per year
- Almost 9,000 patients cared for virtually through our Hospital at Home service each year
- Over 1.7 million vaccinations delivered per year
- Register over 80,000 births per year
- 2,900 staff across Adults, Children’s and Corporate Services
- Care provided from 50 sites (and thousands of patient’s homes)
- Consistently 94% of patients responding to the NHS Friends and Family Test say their experience of HCT services was good or very good
- Annual income of £180m
- 667 GP surgeries we support to record vaccinations
Our people and our culture
None of this would be possible without our staff. They are the heart of our organisation – bringing skill, compassion, and commitment to every interaction.
We are proud of the culture we have built together. Our results have improved each year for the last few years and our 2024 NHS Staff Survey results show that HCT is a place where people feel valued, supported, and able to speak up. Some highlights include:
- 75% of staff would recommend HCT as a place to work – significantly above the national average of 60%
- 85% agree that care of service users is our top priority – placing us in the top 20 organisations nationally
- We ranked second in England for staff retention and job satisfaction (staff saying they were not thinking about leaving the organisation)
- 76% feel safe to speak up about concerns – the sixth highest score among all 263 NHS Trusts
- In the top 2% nationally for access to learning and development opportunities.

These results reflect our unwavering commitment to supporting our people. When staff feel valued and empowered, they provide better care. When they can develop their skills and speak up without fear, our services improve. When they want to stay with us, our communities benefit from their expertise and continuity of care.
We know these figures tell only part of the story and behind each statistic are individual experiences – and not all of them are positive. Some colleagues face challenges we need to address or have experiences that fall short of our aspiration to make HCT a great place to work for everyone. We are committed to understanding these differences and creating a workplace where everyone can thrive. This strategy sets out some specific actions for how we will do that including continuing to support our Shadow Board and staff networks, rolling out our anti-racism leadership programme and events to actively celebrate the diversity within our organisation.
Our partners
We work collaboratively, continuously striving to strengthen our partnerships and develop new ones so that we can provide care, as a whole health and care system, in a way that best supports our population. Our partners come from a variety of sectors, including health and care, education and the third sector, as shown in figure 2.
| NHS | Health and care | Education | Government | Voluntary, Community, Faith and Social Enterprise | Other |
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Integrated care boards (ICBs) Acute trusts Community and mental health trusts Ambulance trusts NHS England and East of England region
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Health and care partnerships Primary care Healthwatch Patients and families Carers
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Universities Schools Colleges
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County and borough councils Central government
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Charities Hospices Faith groups
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Trade unions Regulatory bodies Corporate and comercial companies
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Figure 2. Variety of parthers we work with.
We work with a wide range of organisations and, at a local level, a vast number of GP practices and schools to support the health, wellbeing and education of our population. This includes:
- 667 GP surgeries across the East of England
- Approximately 500 primary schools and 150 secondary schools in Hertfordshire
- 25 Special Educational Needs schools across Hertfordshire.
As with all aspects of what we do, we take a continuous improvement mindset to partnership working and have honest and self-reflective discussions at Trust Board and Board sub-committees. We seek to be a proactive, engaged and supportive partner, however we know that there is variation in partners' experience of us. Going forward, we want to ensure the voice of primary care has greater strength within our governance processes. This strategy puts partnership working as one of our core strategic aims.
The power of community services
Hertfordshire Community NHS Trust is a specialist community provider. We treat people where they live – in their own homes, care homes and community centres. Crucially, we see ourselves as part of those communities.
We believe that only by understanding what our communities need, their hesitations and concerns, and their lived experiences of care can we deliver services that truly meet their needs and actively reduce inequalities.
Our staff occupy a privileged position. They are invited into people's homes during life's most significant moments: welcoming a new baby, supporting families managing long-term conditions, or guiding people through challenging times following injury or illness, and as they approach the end of life. These connections give us unique insight and the opportunity to make a real difference.
Specialist community services have the power to unlock transformational change across the entire healthcare system, improving experiences and outcomes for everyone we serve. Over the past five years, we have responded with agility and creativity to recover from the COVID-19 pandemic, working hand-in-hand with system partners to address shared challenges. We are now integral to the urgent and emergency care sector, responding directly to 999 and 111 calls. Our Hospital at Home service has significantly expanded access to hospital-level care for people in their own homes.
As we look ahead, we will maintain this agile, responsive approach. We will use our skills and unique position as a specialist community provider, working in partnership to drive the improvements needed to meet current and future challenges – and to continuously enhance the care we provide to our population.
As the reorganisation of the NHS takes shape, we have recently moved into the new Central East Integrated Care System, where we intend to actively and enthusiastically support their strategic commissioning intention:
“We will focus on shifting our system toward prevention, early intervention and investment in programmes that reduce avoidable healthcare utilisation, spend and environmental degradation”







