Hospital complex care cuts 'fair'

The Academy of Royal Medical Colleges said complex care such as paediatrics, specialist surgery and obstetrics needs to be centralised to safeguard care.

But the doctors, who carried out the review for the government, said it may be possible for district general hospitals to keep their A&E units.

The Department of Health said it would consider the findings.

The reorganisation of hospital services has been a controversial issue to date.

"This report is about giving the best treatment in the best place at the right time"
Professor Ian Gilmore, report co-author

Advances in medical technology and restrictions on doctors' working hours means it is no longer possible to provide the most up-to-date care from all 200-plus acute hospitals.

Reviews are already taking place in each of the 10 NHS regions in England looking at how care can be delivered.

It has raised fears some hospitals will close and has prompted a wave of public protests up and down the country.

Much of the debate has been about the future of A&E services, but the leading doctors said it was specialist services that were the most under threat.

They said such care should be delivered in regional networks with patients taken straight to their nearest centre rather than the local district general hospital when requiring complex care.

This would mean some hospitals losing their services, with others expanded to create regional centres of excellence.

However, the doctors said the scale of the changes would depend on local need.

And they said A&E departments could still operate for the more minor care the hospital was able to provide.

Best treatment

The report is not to be fully unveiled until next week.

But Professor Ian Gilmore, president of the Royal College of Physicians, who co-authored the report, said: "This report is about giving the best treatment in the best place at the right time.

"It is not about cuts in services, but about using our valuable human resources and buildings as effectively and efficiently as possible."

Shadow health secretary Andrew Lansley said: "We welcome this report. Gordon Brown is misleading patients by saying that district general hospitals should be downgraded.

"These hospital closures are being driven by financial deficits, the European working time directive and the government's belief that bigger is better despite public outcry at limited access."

A spokesman for the Department of Health, which commissioned the study, said: "We look forward to seeing the final report prepared by the Academy of Medical Royal Colleges.

"The report will be a useful contribution for consideration by the local clinical pathway groups under the umbrella of the NHS Next Stage Review."

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