Many local and national NHS initiatives have looked at centralising hospital care, for reasons of both efficiency and quality. Efforts to deliver seven day services could also require a concentration of services at fewer sites, to bring together limited workforce and provide full staffing. Such initiatives often include the downgrading or closure of smaller hospitals – a source of much controversy with the public and politicians.
At the same time, NHS England and NHS Improvement have committed to create viable models for smaller hospitals, particularly in rural and remote areas, as some studies have challenged the idea that centralisation leads to benefits for patients and NHS finances.
This debate asked a panel of policy experts and NHS leaders to discuss whether there is a future for smaller hospitals in the NHS? The panel considered:
- What is the evidence for centralisation?
- Do smaller hospitals still have an important role in the current context? If so, what is it?
- How can this role be maintained in a cash-strapped NHS?