Britain’s current hospital network is unsustainable and must be reformed – even if some smaller hospitals lose services – according to the West Midlands most senior health professional.
Dame Julie Moore, chief executive of University Hospitals Birmingham NHS Foundation Trust, said simply throwing more money at hospitals could make the problem worse, because it “propped up” smaller institutions which were incapable of safely providing the services patients need.
In an interview with the Post, she called for more wide-ranging changes to make the NHS more consistent around the country.
She said: “There are some things we are going to have to tackle. Such as, everyone wants a fully-functional, do-everything hospital in their local vicinity.”
But health professionals and politicians had to explain to the public that this wasn’t always possible, she said.
“The current model is not sustainable and people really need to start looking at how we are going to develop a sustainable model of hospital provision of the future.”
Dame Julie was speaking after 11 hospital trusts nationwide were placed into special measures after a review by Professor Sir Bruce Keogh, NHS Medical Director for England, concluded they needed to improve the quality of their services.
University Hospitals Birmingham NHS Foundation Trust, which runs Queen Elizabeth Hospital in Birmingham, is assisting two of the trusts concerned – Burton Hospitals NHS Foundation Trust in Staffordshire and George Eliot Hospital NHS Trust in Nuneaton – to help them improve, in what is known as the “buddy” system.
Dame Julie was speaking to the Post in an interview to mark her appointment as an Honorary Professor at Warwick University.
She said: “The NHS at its best is amongst the best in the world and I wouldn’t be treated anywhere else. However, it is patchy. The trick for people to pull off, the politicians and the strategy makers, is to get consistency of care across the NHS.”
This meant accepting that smaller hospitals could not provide a full range of services – and then ensuring that whatever they did provide was of the same high quality as at larger hospitals, she said.
“I liken this to a Sainsbury store with a big range of goods, and you also have Sainsbury Local where you have the same quality but a much smaller range of goods on offer.”
She added: “We’re helping two small trusts at the moment as part of the buddying scheme. And what we’ve found is, they’re just not big enough to have the kind of infrastructure that are needed to support modern clinical care.”
Large and small hospitals should work in partnership to ensure staff at smaller institutions were kept up-to-date with medical developments, she said.
“When I have spoken to some staff at places in these small towns they say we need to come and spend some time in a big place to see what the most up-to-date practice is.”
But there was also a need to explain to the public that they would actually get better treatment if some specialist services were centralised in larger hospitals.
“There are some things we are going to have to tackle. Such as, everyone wants a fully-functional, do-everything hospital in their local vicinity. But actually I think we need to explain to people that you get the best clinical results when people are doing enough of a procedure that they gain and retain a proficiency in it. So somebody doing just one operation a year, you are not likely to do well by that, whereas if they are doing 10, 20, 30 you get much better outcomes for the patient. There are a lot of things that need to evolve in the 21st century. And we can’t really exist on a pattern of healthcare provision that really was developed just after the War.
“We’ve got to move on and think about the 21st century and the kind of population and diseases we have, and the knowledge we now have and technology we now have to deliver healthcare.”
She added: “The current model is not sustainable and people really need to start looking at how we are going to develop a sustainable model of hospital provision of the future.
“Putting more money in has actually led to some of the problems, in that you’ve artificially propped up some of the hospitals that really are not sustainable, and that’s probably just delayed some of the decisions that need to be taken.”