More hook wriggling – and now trying to shake off the chains

Initially under the headline “Top Hospitals will run treatments across country”, Chris Smyth in The Times reports 25th September 2015: Specialist doctors will be sent into cottage hospitals

NHSreality wonders if this will include Addenbrooke’s whose latest headline was “Addenbrooke’s staff crisis put patient safety at risk” (chris Smyth 23rd September 2015). It was not chain link that won the wild west but barbed wire. We need to ration by many methods, but the main one is to reduce demand, and it will cause distress. Wales has plenty of barbed wire preventing the sheep from choosing/reaching England.

Specialist doctors will be sent to small local hospitals to “bring more world-class care to the patient’s doorstep” and cut travel time for those who need treatment, the head of the health service will say today.

Simon Stevens, chief executive of NHS England, will say that hospitals are to form chains and set up franchises around the country, marking the end of “go-it-alone” organisations. Local hospitals will be taken over by some of the country’s best or contract out services such as cancer care or neurosurgery to specialist centres. The Royal Free in London and Salford Royal are among leading institutions that plan to set up chains, while Moorfields eye hospital and the Royal National Orthopaedic Hospital will provide specialist treatment around the country.

Mr Stevens argues that this will help small hospitals stay open after a period in which NHS leaders often seemed to be determined to close them in the name of efficiency.

“Rather than patients routinely having to travel to specialist centres, we want to test the idea of bringing that expertise to their local hospital,” he will say in a speech to the Confederation of British Industry today.

“So key departments in smaller local hospitals are in some cases now going to be run by some of the best hospitals in Britain, such as Moorfields, the Royal Marsden or the Christie. This could help support a viable future for many smaller hospitals that are often so important to local communities, and improve the quality and range of services available, reducing the need to travel long distances.

“We’ve got some of the world’s best hospitals and specialists in this country, and it’s right they should be able to extend their reach more widely.”

Thirteen hospitals have been chosen to test the plan. Mr Stevens hopes the successful ones can then be imitated.

Just to remind readers of some of the facts and figures from the past (which will have changed) initially for Wales:

NHS workforce 2013


Where the money goes 2009

and for England

Health spend per head 2000 to 2013


This entry was posted in A Personal View, 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.

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