Expand GP and community services before cutting beds, says Stevens

Local NHS leaders will be required to show that alternative community provision, including GP services, is in place before closing hospital beds in future service reconfigurations.

NHS England chief executive Simon Stevens (Photo: Alex Deverill)
NHS England chief executive Simon Stevens (Photo: Alex Deverill)

NHS England chief executive Simon Stevens will announce later today that major service reorganisations that include cutting bed numbers will only be supported where local organisations can show that patients will continue to receive high quality care.

The announcement following increasing political and public concern over the hospital capacity crisis and the numbers of sustainability and transformation plans (STPs) that plan to cut bed numbers.

BMA chair Dr Mark Porter said it was ‘astounding’ that NHS bosses ‘are still talking about cutting the numbers of beds even though we know that patients are being already unfairly let down by a huge lack of beds in our hospitals’.

NHS reconfiguration

Mr Stevens will announce later today that from 1 April NHS England will only approve significant bed closures where local bodies can show either sufficient alternative provision such as increased GP or community services are in place alongside or ahead of bed closures, and that new workforce will be there to deliver it; or that specific new treatments or therapies will reduce admissions; or where a hospital has been using beds less efficiently than average and has a credible plan to improve performance without affecting care.

The new conditions apply to reconfigurations that are subject to the current formal public consultation tests. STPs are already required to demonstrate support from GP commissioners, strengthened public and patient engagement, clear clinical evidence and provided that they are consistent with patient choice.

Mr Stevens is expected to say: ‘Hospitals are facing contradictory pressures. On the one hand, there’s a huge opportunity to take advantage of new medicines and treatments that increasingly mean you can be looked after without ever needing hospitalisation. So of course there shouldn’t be a reflex reaction opposing each and every change in local hospital services.

‘But on the other hand, more older patients inevitably means more emergency admissions, and the pressures on A&E are being compounded by the sharp rise in patients stuck in beds awaiting home care and care home places. So there can no longer be an automatic assumption that it's OK to slash many thousands of extra hospital beds - unless and until there really are better alternatives in place for patients.

GP capacity

‘That’s why before major service changes are given the green light, they'll now need to prove there are still going to be sufficient hospital beds to provide safe, modern and efficient care locally.’

Dr Porter said: ‘While the principle of this move sounds sensible, it is astounding that NHS leaders are still talking about cutting the numbers of beds even though we know that patients are being already unfairly let down by a huge lack of beds in our hospitals.

‘Improving patient care must be the number one priority for any service changes and the decisions around providing services should be based on clinical needs. At the moment this isn’t happening and there is a real risk that the sustainability and transformation plans are instead being used as a cover for delivering cuts, starving services of resource and patients of vital care.

‘In the short term we need to see bed plans that are workable and focused on the quality of care and patient experiences, rather than financial targets. But in the long term we need politicians to take their heads of out the sand and provide a sustainable solution to the funding and capacity challenges that are overwhelming a health service at breaking point.’

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