Study explores acute medical care in smaller hospitals
A new study commissioned by NHS England – The Nuffield Trust study – seeks to develop a better understanding of the problems associated with acute medicine in smaller hospitals and to find possible solutions. The Nuffield Trust worked with a group of clinical leaders, Royal College representatives and other experts to review the literature, looked at local and international examples and drew on its own research in this area. The researchers focused on hospitals serving 140,000 to 300,000 people, particularly those that are geographically isolated.
A new study commissioned by NHS England – The Nuffield Trust study – seeks to develop a better understanding of the problems associated with acute medicine in smaller hospitals and to find possible solutions. The Nuffield Trust worked with a group of clinical leaders, Royal College representatives and other experts to review the literature, looked at local and international examples and drew on its own research in this area. The researchers focused on hospitals serving 140,000 to 300,000 people, particularly those that are geographically isolated.
The study states that the core principles for redesigning acute medicine in smaller hospitals are: there needs to be a shift from the ‘all or nothing’ understanding of acute service provision to one that is more ‘modular’; smaller hospitals need to be part of a wider system, with strong links to local services and support from other hospitals; smaller hospitals will need to be able to deal with all types of emergency medical cases; working arrangements should be interdisciplinary, team-based and calibrated at ‘whole-hospital level’ to meet the needs of the local population; the benefits of specialist services and staff should be set against the increased costs, fragmentation and threats to viability; systems and processes in hospitals should be organised, as far as possible, with the intention of delivering the appropriate care to the patient as quickly as possible; each step in a patient’s care pathway should add value; and improved continuity of care should be a key objective.
The study puts forward a number of recommendations for action, including: regulators and clinical senates should take a more critical and innovative approach to the application of standards; NHS Improvement and other national bodies should invest in change management to create new models, build functional networks and allow space and permission to experiment; and Health Education England and other regulators should improve how they recognise and respond to the needs of smaller hospitals.
You can view the full report here.