Advising with empathy and experience

Challenge to hospital services.


Dr Michael Dixon, interim president of NHS Clinical Commissioners has suggested that up to 50% of procedures currently undertaken by hospitals should be provided elsewhere.

Dixon, who represents 135 out of 211 clinical commissioning groups (CCGs) said that hospitals may have to downsize or even close, stating that hospitals should be places reserved for those who are very ill or require highly specialised care.

When questioned whether hospitals would face closure because of a decrease in demand Dixon stated “[the aim should be to] hopefully bring down [their number] rationally by some of the commissioning groups coming together and deciding how that is best orchestrated”.

He went on to raise the issue that 70% of hospital beds being occupied by frail elderly patients who could benefit from being cared for at their homes by community health professionals.

The value that the public placed on local hospitals is something that Dixon has not overlooked; he admitted that this isn’t “everyone’s cup of tea” and that CCG’s would need “considerable protection and support” in order to implement the changes that are necessary.

Dixons view that GPs need to lead a “revolution in healthcare” to ease the strain from the NHS which is coming under an “unsustainable” rise in demand caused by an ageing population was supported by the NHS Confederation’s chief executive Mike Farrar.

Farrar stated “As a vision for what the future in healthcare could be like, it’s right. The public’s attitude to hospitals needs to change. We need to explain to people that there are better ways in which we can care for people and that the aim should be to keep people living independently out of hospitals for longer. But to do that we need to take some money that goes into hospitals and put it into primary care and community care services instead”

Some organisations were less favourable towards Dixon’s proposals. The British Medical Association accused Dixon of threatening the financial stability of hospitals and hampering the ability of the NHS to provide specialist care. Speaking of the suggestion, Rachel Griffiths of the CNCI team said "there is clearly a need to examine health and social care services and determine which of these are best provided in a hospital setting. The issue for patients, and our clients, is that of quality of care. If local, community provision is patchy or substandard then these proposals would represent a backward step"