The NHS should replace its traditional general hospital model to improve outcomes and reduce cost pressures, a pair of healthcare experts suggest today.
The proposals come as part of a paper published today by the Social Market Foundation think tank by Nick Bosanquet, former Professor of Health Policy at Imperial College, and Andrew Haldenby, an experienced adviser to public service organisations. Together, they set out a plan (see Notes) for a more efficient NHS, featuring teams led by GPs and including physiotherapists, and counsellors and specialist ‘Dynamo’ operating centres, with the goal of making many trips for hospital treatment obsolete: 30% fewer NHS patients should be attending hospitals in 10 years’ time, the paper proposes.
The £20 billion New Hospital Programme, which entails building 40 new hospitals in England has been beset by delays and rising costs, and largely replaces existing beds, the paper highlights. The Labour Party has signalled that it will review investment into the New Hospital Programme.
Bosanquet and Haldenby argue that it should be cancelled and its funds used to invest in a modern hospital system. A modern system would feature a local GP-led teams – a team of health professionals managing all out-of-hospital services in an area, with the aim of reducing hospital admissions over time. These ‘Neighbourhood Teams’ would be tasked with reducing hospital admissions by 30%.
Without swift action, the paper suggests, the NHS is drifting towards a three-tier system: worst in deprived areas, better in affluent areas and with more people buying private care. Maintaining the district general hospital model prevents policymakers from addressing Britain’s changing health needs, and obstructs the NHS from making necessary efficiencies.
A patient could be treated by their neighbourhood team of healthcare professionals at home, resulting in a more cost-effective outcome than hospital-based care, with the potential to treat four times as many patients in a month (see Figure 1). Neighbourhood Teams would also maintain continuity of care, which is becoming a more important requirement, given the rise in long term conditions which have physical and mental health elements.
Neighbourhood Teams would be complemented by “dynamo centres”, with more operating capacity than the new surgical hub units – and should be modelled on the South West London Elective Orthopaedic Centre (rated “among the best in the country”). These would be highly specialised, and treat a large enough area such that 24/7 staffing by consultants would be viable. The specialisation and concentration would boost output and success rates, ultimately bringing down waiting lists.
Remaining District General Hospitals would then be left to focus on providing A&E services, and work with Neighbourhood Teams.
Nick Bosanquet, Co-Founder of Aiming for Health Success and former Professor of Health Policy at Imperial College, said:
“The NHS’s enormous current resources can deliver a faster, better service within months, even in a climate of great pressure on public spending.”
