What a privilege it is to visit other countries and witness firsthand their health and care services within their culture.
My colleague Jo Posnette and I were invited to visit Japan for a study tour of community hospitals and to have a chance to participate in a Community Hospitals Summit. It was an amazing opportunity, and we were grateful to Dr Honda and colleagues for making it possible. This was a reciprocal visit, as previously we had shown Dr Honda and colleagues community hospitals in Gloucestershire and they had attended our CHA national conference. We were so pleased to make the connections and share our learning about our respective services.
Community Hospital Japan (CHJ) has been established by Dr Honda and is similar in aim to our own organisation, the Community Hospitals Association (CHA). We are both networking organisations promoting and supporting community hospitals. The CHA is a voluntary membership organisation working to raise the profile of community hospitals nationally and internationally.
Japan has a network of 36 community hospitals. They offer what they describe as holistic care: “Community Hospital – a model providing continuous care from prevention in the community to end-of-life care at home.” Although larger than community hospitals in the UK in terms of bed numbers, with fewer than 200 beds, the model of care is very recognisable. They are generalist hospitals led by local physicians offering intermediate care, with a strong focus on rehabilitation and palliative care. We visited three community hospitals.
Ouchi Ni Kaerou Hospital, Tokyo
The first hospital translates as “Take me Home” Hospital, which describes its ethos “Living at home, living my own life.” It is a modern building, built five years ago, and created to encourage independent living through offering rehabilitation and ongoing support. It has 120 inpatient beds for those recovering from surgery, requiring rehabilitation, and receiving palliative and end-of-life care. It does not offer outpatient clinics. We were struck by the way that the ethos of care was described in a very heartfelt and moving way. The design of the hospital and delivery of care reflects person-centred care, central to integrated care.
Dozen Community Hospital, Tokyo
Dozen Hospital is a collection of three older buildings in a built-up city area. Although the environment is very different, the ethos and model of care were the same. The staff spoke of the importance of intra-hospital and extra-hospital collaboration and demonstrated their wide reach across the community. This was focused on the Community Support Room, which aims to foster intra-hospital integration through regular medical and social conferences, multidisciplinary meetings to review admissions, pre-discharge bed management and home care, among other activities. The Community Support Room is also used for extra-hospital collaboration, such as working with voluntary health and welfare agencies, community pharmacies and long-term care facilities.
Kaita Hospital, Fukuoka
This hospital is a success story, having been rescued from recruitment and financial problems by Dr Honda. The hospital now has a clear, explicit purpose, and offers a wide range of services including inpatient care, outpatients and renal dialysis. Rehabilitation is at the heart of the services provided and is offered to patients for two hours every day, seven days a week. Patients walking with physiotherapists were evident throughout the hospital. Patients benefit from the hospital having an integrated “hospital and home care” service, with home care teams led by doctors working from the hospital. We were honoured to be invited on home care visits and observed the high quality of care provided by clinical staff visiting monthly. We were made very welcome by patients and their families and invited to return when the cherry blossom was in full bloom!
Community Hospital Japan (CHJ) Summit
There was so much to learn from the presentations given on how community hospitals impact their communities. We heard examples of where the role of local community hospitals extends beyond health and social care to supporting community wellbeing initiatives and offering health promotion and healthy living support. It was fascinating to hear presentations from different areas in Tokyo, Hiroshima, Fukuoka and the surrounding areas on Kyushu Island. We also heard from colleagues in Singapore, who spoke of many initiatives to promote healthy living and fitness, particularly in older people.
Integration
We understood that some of the ambitions for developing multidisciplinary services may be restricted because of the insurance system and requirements from medical staff. However, we witnessed intra-hospital and extra-hospital collaboration, multidisciplinary working and progress in integrating hospital and home care. Japan ranks among the countries with the highest life expectancy so we were particularly keen to observe services for older people.
Impressions
We were impressed with the enthusiasm and sense of purpose in the hospitals and also shared in presentations at the Summit. We were pleased to make such good connections with colleagues in Japan, and this continues with our mutual attendance at our respective conferences. We plan to capture some of the learning in a paper, and between us promote the view that “small is beautiful.”
International Network
The CHA is working with the International Foundation for Integrated Care’s (IFIC) Intermediate Care Special Interest Group (SIG) to facilitate an international community of practice on community hospitals. We have held two webinars on international community hospitals and had presentations from countries such as Sweden, Italy, Singapore and Canada as well as Japan. Please see further information here.
Our next webinar will be Wednesday, 16 September 2026 at 4:00pm GMT.
Dr Helen Tucker MBE
Fellow of Community Hospitals Association
Acknowledgements
Our thanks to Dr Yoshisha Honda, CEO of Kaita Hospital and Founder of CHJ.
Kaita Hospital
Left to right: Jo Posnette, Chair of CHA; Helen Tucker, Fellow of CHA; and Dr Yoshisha Honda, CEO of Kaita Hospital and Founder of CHJ
Dr Helen Tucker
Community Hospitals Association