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. 2015 Jun;2(2):137-141.
doi: 10.7861/futurehosp.2-2-137.

The reconfiguration of hospital services: is there evidence to guide us?

Candace Imison  1
Affiliations

The reconfiguration of hospital services: is there evidence to guide us?

Candace Imison. Future Hosp J. 2015 Jun.

Abstract

Many argue that the solution to the NHS's quality and financial problems lies in the continuing reconfiguration and centralisation of hospital services. However, an ageing population requires good local access to care. This paper reviews the evidence that is available to help guide the reconfiguration of hospital services. The quality overall is poor and, in particular, there is little evidence that reconfiguring hospital services results in financial savings. For acute medical care, there is strong evidence both for enhanced direct and early consultant involvement, and for the importance of comprehensive supporting services. Clinical networks and new technologies may offer opportunities to sustain local access but more evidence is needed to guide network development and to ensure safe but sustainable medical staffing models.

Keywords: National Clinical Advisory Team; Reconfiguration; access; clinical services; finance; quality; safety; workforce.

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Figures

Fig 1.
Fig 1.
The five drivers of clinical service reconfiguration.
See this image and copyright information in PMC

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