Downsize or Shut Down more hospitals to improve service, says NHS Chief

12 February 2014

Downsize or Shut Down more hospitals to improve service, says NHS Chief

The outgoing NHS chief Sir David Nicholson says that the NHS needs to strip down its services in order to sustain resources and offer patients better care; he further envisages a smaller number of larger hospitals offering the vast majority of major surgery options.

Sir David was writing in the Telegraph newspaper with a warning that in order to sustain better patient focused care, the health service needs to shrink the size of services actually offered with fewer hospitals offering the most major surgery, and with many of the smaller hospitals withdrawing the offer of current services.

Nicholson received widespread criticism in the media and by health campaigners after the Francis Report into the deaths of hundreds of patients at Stafford Hospital was published last year. Nicholson was specifically criticised as he was in charge of the regional health authority responsible for the hospital when most of the failings in 2005 and 2006 occurred.

“Fragmented and confusing”

In his article in the newspaper, Sir David has spoken of the need for the NHS to adapt in order to survive and believes the current system is “fragmented and confusing” for patients, and so directly compromises the level of care they are currently receiving. He warned that the current operating system does not help an ageing population and that widespread reorganisation is vital for much needed change.

He says: “I believe the NHS needs to embark on a programme of transformational change to front-line care, arguably the most significant since its creation.”

“We face a big financial problem for the future”

“Like every major health system in the world, we face a big financial problem for the future: the sums don’t add up,” he added in the article.

“If we don’t change, we face a funding gap that could be £30 billion by 2021.

“We know that centralised, large units, with concentrated expertise and technology, work best in providing the most effective care. So we need to ensure this approach is applied to other parts of the health service, for people with very rare conditions, and for significant planned surgery.” receives enquiries from members of the public concerned about the lack of funding available for emergency services and other departments in hospital such as paediatrics and oncology. It is a usual concern that patients who call through to us feel they are not being listened to and that when poor care is flagged up, nothing seems to be done to meet their concerns. This only reinforces the negative impact poor medical mistreatment has on those who speak to us whether in raising a complaint or wanting to pursue a medical negligence claim.

“Too much focus on buildings and not enough on services”

He suggested that without radical change, services will not be sustainable.

“Our NHS does a superb job for millions of people, day in day out, but it cannot stand still – it needs to adapt to survive,” he writes.

“The NHS proposals for change always come with controversy,” he further said. “Too often the overall public interest gets lost in a debate about winners and losers with too much focus on buildings and not enough on services.

“This time I hope the NHS, the public, policymakers and politicians will join forces to make it happen. As someone who has spent 30 years working in the NHS, I know it matters too much to get it wrong.”

Nicholson added that it was important the NHS makes it a priority to “listen to patients and act on their concerns”. He also felt that technology needed to keep up with the times and to meet the demands of an ageing population, and that this mirrored the need for citizens to feel “fully empowered and included in all aspects of the NHS.” was created to listen to talk to people who feel that they had nobody at the NHS to listen to them when something went wrong. Members of the public who call through to us often want to raise an issue within NHS care so that somebody else is not affected the way their and their loved ones have been. Sometimes they call through to us to make a medical negligence claim because a financial settlement is needed to rebuild their life and to take care of their family. If you have experienced a form of medical mistreatment through emergency services, A&E or through surgery, for example, you can speak to the experts at