Letters I’m a healthy patient; get me out of here

England must support its community hospitals

BMJ 2016; 354 doi: https://doi.org/10.1136/bmj.i3933 (Published 19 July 2016) Cite this as: BMJ 2016;354:i3933
  1. David Seamark, general practitioner1,
  2. Helen Tucker, vice president2,
  3. Heather Penwarden, chair3
  1. 1Honiton Surgery, Marlpits Lane, Honiton EX14 2NY, UK
  2. 2Community Hospitals Association, c/o CHA Office, Horton, Ilminster TA19 9QX
  3. 3Honiton Hospital League of Friends, Honiton Hospital, Honiton EX14 2DE
  1. david.seamark{at}nhs.net

Appleby highlights the plight of acute hospital patients with delayed discharge because of waiting for assessments and transfers to other NHS facilities.1 We note an overlooked and neglected NHS resource: community hospitals. The UK has around 500,2 and Simon Stevens, NHS England chief, made a statement supporting improved local access to services and full use of these hospitals.3

Of the 362 community hospitals in England, however, at least 53 have lost inpatient facilities. Outside England, their potential is being recognised. Norway has legislated for local authorities to provide services as alternatives to acute hospitals.4 Italy has a legal requirement of 0.7 beds per 1000 inhabitants for rehabilitation and long term care.5 The Scottish government recognises the importance of community hospitals and has a clear development strategy.6 7 Action is needed.

Firstly, the NHS must stop the indiscriminate closure of beds and hospitals.

Secondly, evidence is required for the clinical and economic effectiveness and community value of these local facilities. The National Institute for Health Research supports a programme of three research studies on exactly these issues.8 9 10 The NHS should allow these studies to be completed and analysed before further radical and irreversible changes take place. The UK parliamentary health select committee is considering whether to have an inquiry on the role of community hospitals: let’s hope that the deliberations lead to authoritative guidance for the NHS.


  • Competing interests: DS works as a GP in community hospitals. He is a member of the research steering group for the NIHR funded Community Hospitals Study: a comprehensive profile and comparative analysis of the characteristics, patient experience, and community value of the “classic” community hospital situated in contrasting contexts and communities. HT is vice president of the Community Hospitals Association, runs a health services consulting company (Helen Tucker Associates), and is a steering group member of the above mentioned research group. HP is chair of the Honiton Hospital League of Friends.

  • Full response at: www.bmj.com/content/353/bmj.i3585/rr-3.


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