By Richard Johnstone | 13 June 2014
Small district hospitals must overcome financial challenges if they are to survive and thrive as part of the NHS, Monitor has warned.
The health sector regulator has today published the results of its examination of clinical and financial indicators that tested whether any special factors affected the performance of hospitals with fewer than 700 beds.
The Facing the future: smaller acute providers report found there was no clear evidence that smaller acute hospitals performed any worse in clinical terms than larger counterparts.
However, financial performance had worsened more than the sector as a whole over the last two years, and providers told the watchdog they were concerned about the scope for achieving further efficiencies.
Monitor chief executive David Bennett said smaller hospitals were facing increasing challenges as the NHS takes on a potential £30bn funding gap over the next decade.
However, he added they can continue to play an important role in the nation’s health service if they are able to re-design services to improve the integration of care and come up with creative ways to address challenges of scale, such as sharing staff with nearby trusts.
‘Bigger isn’t always better and just merging or taking a “one size fits all” approach to local health services is not the answer,’ he added.
‘We need to achieve the right balance between risks to quality and risks to access, and consider other constraints such as the impact of clinical specialisation to make sure patients continue to benefit from the local hospitals that they value so much.’
Responding to the report, Terence Stephenson, chair of the Academy of Medical Royal Colleges, said: ‘Providing the right services for patients in the right place that can be financially and clinically viable is one of the NHS’s absolutely key challenges.
‘It is clear from this report that that there are no simple conclusions or answers to these questions. But the report provides the service with a useful base for taking forward thinking and practical action.’
