New NHS chief Simon Stevens backs more local hospitals and “must end mass centralisation”

BBC News reports 30th May 2014 an apparent change in direction: New NHS chief Simon Stevens backs more local hospitals

Smaller community hospitals should play a bigger role especially in the care of older patients, the new head of the NHS in England has said.

In an interview in the Daily Telegraph, Simon Stevens signalled a marked change in policy by calling for a shift away from big centralised hospitals.

The health service chief executive said there needed to be new models of care built around smaller local hospitals.

The NHS said he was not suggesting the return of 50s-style cottage hospitals.

In recent years the health service has emphasised the benefits of centralised services.

This has paid dividends in areas such as stroke care and major trauma where significant benefits have been gained by concentrating specialist care.

But this has raised questions about the future of the many smaller district general hospitals across the NHS.

In the interview in Friday’s paper, Mr Stevens said they should play an important part in providing care, especially for the growing number of older patents who could be treated closer to home.

He said: “A number of other countries have found it possible to run viable local hospitals serving smaller communities than sometimes we think are sustainable in the NHS.

“Most of western Europe has hospitals which are able to serve their local communities, without everything having to be centralised.”

In the home

He said elderly patients were increasingly ending up in hospital unnecessarily because they had not been given care which could have kept them at home.

Mr Stevens also told the Telegraph:

  • The NHS needed to abandon a fixation with “mass centralisation” and instead invest in community services to care for the elderly
  • Waiting targets introduced by Labour became “an impediment to care” in too many cases
  • The European Working Time Directive damaged health care in the NHS, making it harder to keep small hospitals open
  • Businesses should financially reward employees for losing weight and adopting healthy lifestyles

An NHS England source said Mr Stevens was saying that smaller hospitals had a part to play in shifting services into the community, not that there would be no closures of local hospitals in the future.

Mr Stevens, a former adviser on health to Tony Blair, will outline his vision for the NHS in a major speech at the NHS Confederation conference in Liverpool on Wednesday.

He took up the post of chief executive of the NHS in England after 11 years working for private health care firms in Europe, the US and South America.

It is reasonable to ration care by not sending everyone to super-specialist centres. Local care, especially for the commonplace non-technical is best, and most appreciated. Patients can often return to the local unit from technically specialist centres very quickly.. Commissioners in rural areas need to take note.. But this does not excuse Mr Stevens avoiding the “R” (Rationing) word so far..

This entry was posted in A Personal View, Commissioning, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

1 thought on “New NHS chief Simon Stevens backs more local hospitals and “must end mass centralisation”

  1. Pingback: Is it progressive to reduce us all to same day appointments? | NHS reality. An NHS soapbox. Speakers' corner for the NHS.

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