The NHS needs financially viable models to ensure that services can be sustained in the long term against a background of an ageing population, more treatable conditions, expensive drugs, increasing disease prevalence and more high tech equipment.
What must be avoided is poor clinical quality in diagnosis and treatment, duplication of diagnostics, unnecessary appointments and poor clinical outcomes.
As yet, there is no consensus about the best approach to delivering smaller clinical services in this context. There is a risk they will either be subsumed by bigger teaching hospitals or scattered across primary care, neither of which will enhance the quality of local care or support the sustainability of DGHs. Whole-system solutions will need to implemented in order to sustain smaller clinical services.
Single specialty networked care can offer local service sustainability and can be embedded in large-scale transformation planning in hospital groups, mergers and STPs. Of critical importance is identifying where the expertise exists and then seeing how best to share that expertise across a wider geography and developing the right partnerships to achieve this.
Implementing networked care is one way in which clinical services can continue to be delivered locally, avoiding the need for patients to travel further, and preventing local services becoming diluted and isolated with lower standards, compromising care.