Plans to concentrate West Midlands hospital services in “centres of excellence” have been backed by Health Minister Lord Darzi.
Setting out a 10-year plan for the NHS, Lord Darzi said patients needing emergency treatment were more likely to survive if sent to specialist centres.
The proposals would mean the closure of services in the region’s hospitals, including departments which treat heart attack and stroke patients.
Instead, the NHS will focus on preventative care at a very local level, in GP surgeries, health centres or people’s homes, and providing world-class emergency treatment in specialist centres.
Lord Darzi’s proposals included funding hospitals partly on how patients rated the bedside manner of doctors and nurses. Hospitals which treated patients with dignity and compassion would receive higher budgets.
His recommendations were based on reports published this month by regional health authorities, including a study by NHS West Midlands which concluded services should be merged.
The report said: “In the West Midlands, some concentration of the most specialist emergency services into major emergency departments is necessary for the best quality of care for patients with, for example, stroke, heart attacks and major trauma.”
It added: “A concentration of some specialist activity in fewer centres where the evidence shows unequivocally this delivers better outcomes. Services where this change will need to occur (and is occurring already in some areas) include acute stroke centres; primary angioplasty for heart attack; major trauma; complex emergency surgery; inpatient paediatrics (with much that is currently inpatient continuing to be treated locally in new specialist assessment services); high risk obstetrics.”
The new proposals endorsed the plans, one of a number of so-called “visions” published by regional health authorities.
Lord Darzi said: “The visions have sent a powerful message the most effective treatments should be available for all NHS patients.
“Their plans for transforming treatment for heart attack, stroke and major trauma vividly illustrate this.
“For stroke – the third largest cause of death and single largest cause of disability in the UK – the clinical evidence clearly demonstrates the quality of care is greatly improved if stroke is treated in specialist centres.”
His proposals included introducing a greater focus on quality of care, such as “the compassion, dignity and respect with which patients are treated.”
Recommendations included making funding for hospitals reflect the quality of care patients receive.
The report said: “For the first time, patients’ assessments of the success of their treatment and quality of their experiences will have a direct impact on the way hospitals are funded.”
For a district general hospital about £7 million to £9 million a year will be dependent on factors like outcomes and patient satisfaction.
Many of the details in the report had already been announced, including the speeding up of drug appraisals by the National Institute for Health and Clinical Excellence (Nice).
Personal health budgets for people with conditions such as diabetes or multiple sclerosis will also be piloted to give patients greater control over their care.
There is a focus on preventing ill health, with the creation of a Coalition for Better Health, which will initially look at tackling obesity. The 12-month review involved consultations with 60,000 patients and staff and has been hailed by the Prime Minister as a “once-in-a-generation opportunity” to make the NHS one of the world’s best systems.
Other rights include the right to choose a GP practice and the right to express a preference for choosing a particular doctor.
Health Secretary Alan Johnson said: “These locally driven, clinically led plans show how quality of care will be raised right across the country, with doctors and nurses supported to offer big improvements in treatment at the bedside.
“Quality of life will be improved and more lives will be saved.”