The hospital is dead, long live the hospital: sustainable English NHS hospitals in the modern world

Document type
Corrigan, Paul; Mitchell, Caroline
Date of publication
1 September 2011
Health Services
Social welfare
Material type

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NHS hospitals currently try to be all things to all people and deliver every healthcare service to everyone. This is no longer clinically no financially sustainable and it holds the NHS back from delivering better, safer and higher quality care.This report summarizes the pressures facing hospitals in England and proposes key ways in which national policy can support the emergence of better models of healthcare delivery:

  • No bailout for the NHS: the learnt behaviour in the NHS is that the Chancellor will always find more money to avoid the embarrassment of a hospital closure. This weakens the case for change for NHS leaders and confuses the incentives for all in the system. For hospitals to change they cannot believe the Government will bailout them out.
  • Better commissioning: commissioners acting on behalf of patients should disinvest in expensive and poor quality acute services and instead invest more resources in primary and community care, forcing incumbent hospitals to change the services they provide or go out of business.
  • Intensify market pressures: greater patient choice and new providers will create real incentives for NHS hospitals and other service providers to modernise to deliver better services at a lower cost.
  • Failure regime: the Government must set out a clear, transparent and enforceable failure regime for hospitals. This will force hospital leaders to change their business models and empower other organisation to intervene and turnaround failed institutions.

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