Hospital reorganisation urged

Hospitals need to be reorganised so very ill patients are not moved unless absolutely necessary, a special investigation has found. A commission by the Royal College of Physicians published 50 recommendations for the NHS to improve care.

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'More doctors needed to lower death rate'

The NHS does not have "as many" doctors per hospital bed as we need to lower the death rate, a former head of the British Medical Association has said.

Dr Brian Jarman echoed comments made by a Royal College of Physicians report that patients were more likely to die at the weekend because there were not enough staff.

He added: "Complaints by the moment don't investigate 99.7% of them. What industry would do that?"

Hunt backs 'patient-centred' hospital reorganisation

Care should be reorganised around the patient "both inside and outside hospital", the Health Secretary said.

He was echoing comments made in a report on the future of patient care by The Royal College of Physicians, who want to see a focus on smaller, community hospitals to meet the needs of an ageing population.

I agree completely with the RCP that we must make services more patient-centred, both inside and outside hospital.

Their focus on patient experience and a 'buck stops here' approach for senior clinicians is bold and refreshing.

I'm pleased that many of the proposals in this important report mirror and build on the steps we're already taking to drive up standards across the NHS, including named clinicians, prioritising and measuring patient experience, and seven-day access to services.

– Health Secretary Jeremy Hunt


Labour: All incentives 'working in the wrong direction'

Patient care incentives are "working in the wrong direction" pushing the sick towards hospital care even if it is not in their best interest, the Shadow Health Secretary has said.

Labour's Andy Burnham said his party were "building a new vision for the NHS" based around care for "the whole person".

Labour is building a new vision for the NHS as a single service that looks after the whole person. We want to see one team looking after all of one person's needs - physical, mental and social - seven days a week. This important report offers new thinking on how to get there.

Right now, all the incentives are working in the wrong direction: pulling patients towards the hospital even if they don't need to be there. We must turn this system around and help support people where they want to be - at home with their family around them.

– Shadow Health Secretary Andy Burnham

RCP: Focus on smaller hospitals for better care

Hospitals should be reorganised around "hub and spoke" care, with a focus on smaller, community facilities, according to the Royal College of Physicians.

It is likely that in many areas, large health economies will be served, not by a number of district general or teaching hospitals, but by a smaller number of acute general hospitals hosting emergency departments and trauma services, acute medicine and acute surgery.

These hospitals will be surrounded by intermediate 'local general hospitals' which, while not directly operating their own emergency department and acute admitting services on site, will contribute to step-down inpatient and outpatient care, diagnostic services and increasingly close integration with the community.

– RCP report "Future Hospital: Caring For Medical Patients"

NHS needs to run at full steam 'seven days a week'

According to the Royal College of Physicians if NHS care is going to meet the needs of more elderly patients it needs to:

  • Give access to medical labs and scans on weekends as well as weekdays.
  • A consultant should be present on the ward at all times, with ward care "prioritised" in their job plans.
  • Rotas should be planned and written on a seven day rotation.
  • A new chief resident will work with junior doctors and help plan service design and delivery, including rotas, duties and workload.

Hospitals urged to focus care solely around patient

Scanning equipment and lab tests must be available over weekends, a report from the RCP has said. Credit: PA

Care should come to very sickly patients so they do not have to move around the hospital unless medically necessary, a special investigation has found.

A commission set up by the Royal College of Physicians (RCP) put forward 50 recommendations which would allow the NHS to integrate care around the patient and face the complex health needs of an ageing population.

"Future hospital; caring medical patients" warns hospitals are "struggling to cope" with the rise in and multiple needs of older patients, while units are not equipped to provide excellent care on weekends.


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