Feature NHS Reforms

How will secondary care need to shape up to survive? A roundtable discussion

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e4384 (Published 27 June 2012) Cite this as: BMJ 2012;344:e4384
  1. Rebecca Coombes, features editor
  1. 1BMJ, London WC1H 9JR, UK
  1. rcoombes{at}bmj.com

At a roundtable session in London this month the BMJ assembled clinical and managerial experts in secondary care and beyond to discuss the future of this sector over the next decade. Rebecca Coombes led the debate

Secondary and tertiary centres will have to respond to the new landscape of competition with non-NHS providers, and enter a new era of cooperation with primary care as general practitioners become lead commissioners in healthcare. Throw in the need to make efficiency savings the like of which the NHS has not seen before—4% a year until 2015—and the challenge is daunting. The session was chaired by the BMJ features editor, Rebecca Coombes, and attended by Yi Mien Koh, chief executive of Whittington Health in London; Jan Filochowski, chief executive of West Hertfordshire Hospitals NHS Trust; Fergus Gleeson, divisional director of critical care, theatres, diagnostics, and pharmacy at Oxford University Hospitals; Nigel Edwards, senior fellow at the King’s Fund, the health think tank; Derek Greatorex, chair of South Devon and Torbay Clinical Commissioning Group and a general practitioner; and Kate Hall, policy adviser at the NHS foundation trust regulator, Monitor.

Rebecca Coombes: What do you think secondary and tertiary care will, or perhaps should, look like in five years’ time?

Derek Greatorex: As commissioners we’re moving away from the idea of the hospital as the secondary care setting. We’re going to have to see a move towards more community based services and perhaps consultants moving out of the traditional hospital setting. I think patients are beginning to expect it. Some of our secondary care colleagues are embracing this, and others see it as a challenging future for them.

Jan Filochowski: I think we’ll see even shorter waits. I don’t think people will be happy with even the level of waits they have now—even though …

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