Reconfiguring acute hospital services

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Education and debate p 845 Acute hospital services throughout the NHS need to be reconfigured, but it's unclear how best to do so. We can, however, probably agree on some principles. That was perhaps the main message from a meeting in held in Cambridge last year by the Anglia and Oxford region of the NHS Executive. The meeting, and also a series that starts today in the BMJ (p 845), make it clear that a national master plan, like the one that set up district general hospitals, is neither wanted nor probably possible. Those at the conference took a show of hands on what was driving the need for reconfiguring acute services. Almost everybody thought that what should be driving it was the need to improve quality but that what actually was driving it was the need to reduce costs and cope with staffing problems, new technology, and public expectations The medical profession—represented by the BMA, the Royal College of Physicians of London, and Royal College of Surgeons of England—is convinced that “Comprehensive medical and surgical care of the highest quality requires the concentration of resources and skills into larger organisational units.”1 …

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