Centralisation of services
Centralisation produces large urban hospitals that provide specialised care. These work on a hub-and-spoke model with patients from rural areas being stabilised and transferred to the centralised hospital site for treatment. This type of model particularly affects ICM, as there are only large ICUs that staff intensivists. Large multidisciplinary teams provide better outcomes for patients.
Proposed workforce impact
- It could mean greater demand for single-CCT ICM.
Sources or references
- www.rcseng.ac.uk/publications/docs/Centralisation%20and%20specialisation%20of%20hospital%20services.html
- bma.org.uk/news-views-analysis/news/2012/october/nhs-services-face-centralisation
- www.kingsfund.org.uk/blog/2011/09/reconfiguring-hospital-services-bold-move-improve-health-care
Additional research questions
- Will economies of scale or concentrations of expertise provide more efficient care?
- Will there be the political will and expenditure of political capital to close services, to allow services to be relocated?
- Will there be ‘skill decay’ in the spoke hospitals and, if so, how should this be mitigated?
Some of the information in this section is provided by stakeholders and expert groups, and does not necessarily represent the views of the CfWI.
