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How best to organise acute hospital services?

BMJ 2001; 323 doi: (Published 04 August 2001) Cite this as: BMJ 2001;323:245

Think completely differently

  1. Richard Smith, editor
  1. BMJ

    The Royal College of Physicians and the NHS Confederation have announced a working group to rethink the delivery of acute emergency services in hospitals. It is, says their press release, “one of the biggest problems faced by the NHS.” And, says George Alberti, college president: “We need completely new thinking to solve the problem—not just refinements of the present system.”

    The current arrangement of acute hospital services in Britain becomes ever less efficient and more dangerous. Yet the political cost of reorganisation is rising. The government lost a safe parliamentary seat in Wyre Forest because of its plans to close Kidderminster Hospital.1 A current minister, Yvette Cooper, faces potentially the same problem in her constituency. So the time has clearly come to think differently, and a recent meeting in Cambridge of the Eastern Region of the NHS on acute services heard a radical proposal to reverse current thinking. Instead of the current fashion for ever larger acute hospitals with local hospitals taking patients discharged from the large hospital, patients with emergencies might go first to the local hospital—but to one very different from now. …

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