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Letters Service redesign

Rigorous science is needed to justify the centralisation of services

BMJ 2014; 349 doi: (Published 01 July 2014) Cite this as: BMJ 2014;349:g4324
  1. John S Yudkin, emeritus professor of medicine,1
  1. 1University College London, London N7 0AG, UK
  1. j.yudkin{at}

Simon Stevens’s address to the NHS Confederation stated the need for rigorous testing of new approaches to service delivery.1 In the same speech he also held up London’s reform of stroke services to justify the centralisation of services. His evidence was based on a before and after study showing a “12% reduction in death rates.”

The study compared outcomes for patients treated for …

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