Hospitals must get smaller to stop NHS ‘permacrisis’, thinktank urges | NHS
Hospitals need to be smaller and with fewer beds to save the NHS from “permanent crisis”, a think tank has said.
The role hospitals play in helping them recover from the overcrowding that has become widespread over the past decade needs to be “fundamentally reinvented”, the report says. thinktank Answer:Government.
The report also says politicians and NHS leaders must be prepared to implement a potentially controversial program to downsize hospitals if the service is to survive.
The think tank, formerly Reform, argues in a new report that this would save the NHS billions of pounds, ensure better care for patients and ease pressure on overworked staff.
Hospitals may shrink in size and shed thousands of beds as a result of the massive expansion of care provided in and near people’s homes. People would need to go to or stay in hospital much less if they had access to diagnostic tests, outpatient appointments, and treatment at home or in community settings, reflecting the changing nature of diseases brought on by an aging population, the report says.
Rosie Beacon, author of the report, said: “This is less about bed counts and more about what hospitals do and how they do it. Hospitals can become smaller because you can give people the same standard and often a better range of care without being physically there. [would produce] lower long-term operating costs and a financially sustainable system.
“Hospitals should be downsized not just for this, but because how and where we provide secondary care no longer needs to be limited to hospital beds.
“The natural consequence of a healthcare service that manages to reduce hospital congestion through better prevention and faster treatment is that hospitals look smaller and different. Being honest about this isn’t radical; it’s just confronting what a modern, preventative NHS requires.”
He added: “The shrinking hospital footprint is a result of care becoming faster and more effective. This is not about cutting services. It is about delivering them in faster, more convenient and more financially sustainable ways.”
The supply of general and acute beds in hospitals in England fell from 180,889 to 180,889 in 1987-88. 100,916 last monthNHS England figures show. Advances in treatment have allowed patients to stay longer, relieving pressure on beds. But hospitals need to create thousands of extra beds to help them cope with the usual “winter crisis.”
Prof Joe Harrison, chief executive of Milton Keynes university hospital NHS Trust, said: “The only way to stabilize the service, improve access and quality of care and ease the pressure on tired staff is to radically rethink what hospitals do and how they do it.”
The scale of the crisis facing the NHS is so great that bosses “must be prepared to ask the tough questions and make tough decisions” about how services are delivered, he said.
In the foreword to Re:State’s report, senior executives from the NHS Confederation and NHS Providers, which represents England’s 215 health trusts, support the idea of radical reform of hospitals.
Matthew Taylor and Daniel Elkeles say that although the NHS was “visionary” when it was founded in 1948, “the founding vision has become increasingly fragile”. “The globally respected NHS has become a service based on waiting rather than improving. A model designed in 1945 is not fit for 2025. Redesigning the hospital, the most expensive part of the system, must be at the heart of service reforms.”
A spokesman for the Department of Health and Social Care said it was already shifting care from hospitals as part of “three major shifts” to reinvigorate the NHS.
“Pioneering neighborhood health centers will give people easier and more convenient access to a full range of healthcare services right on their doorstep, saving them from long journeys to the hospital,” the spokesperson said.
“Community diagnostic centres, many of which are open 12 hours a day, seven days a week, allow people to get tests, checks and screenings closer to their homes, again reducing the burden on crowded hospitals.
“Hospitals of the future are being built with more single patient rooms, careful consideration of demographics, and maximizing cutting-edge technology for greater efficiency and sustainability.”
