Service Reconfiguration

06.09.11

Hospital closure decisions should not be made by ministers – King’s Fund

Closing hospital services would improve safety and treatment, according to a briefing paper by think tank the King’s Fund that echoes arguments made by senior health professionals in recent months.

But it recommends removing ministers from the decision-making process, as local politics so often frustrates any attempt to restructure and reconfigure services, despite the urgent need for more community care and fewer district general hospitals.

Candace Imison, Deputy Director of Policy at The King’s Fund, and the author of the paper, said: “Politicians have an important and legitimate interest in how health care is provided locally but too often act as a barrier, rather than facilitating the honest dialogue needed with the public.”

The report authors also suggest that minimum quality standards should be set and if hospitals are unable to meet them, they should be prohibited from providing these services.

The move to close services at certain hospitals in order to concentrate resources and expertise in fewer establishments has seen support from several medical experts, including most recently, former NHS chief executive Lord Crisp.

The King’s Fund argues that reconfiguration is often politicised, with many ministers opposing hospital closure as it is largely unpopular with the public. To improve this, they propose that the Independent Reconfiguration Panel should have the final word in decisions on closure, instead of the Health Secretary.

Imison explained: “Changes to the way hospital services are organised in some parts of the country are now a necessity, not an option, if the NHS is to deliver safe, high quality care.

“With the NHS facing growing financial pressures and difficulties in recruiting staff with the right skills, politicians must grasp the nettle on this - not to do so risks allowing the continuation of poor quality and potentially unsafe services.”

Sir Richard Thompson, president of the Royal College of Physicians, commented: “There is an urgent clinical need to reconfigure acute services primarily to drive up quality, as well as to contain cost. The current system is often lengthy and wasteful.

‘The RCP agrees that clinical leadership should be strengthened to lead the reconfiguration process. Local clinicians should be at the heart of reconfiguration decisions, as they are best placed to understand the health service needs of their local communities.”

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