Specialist hospitals and the transformation of the NHS | Phil McCarvill

Phil McCarvill

As a new report from the Innovation Agency and UCL Health Partners underlines specialist hospitals have a vital role to play in transforming the way health services are delivered, Dr Phil McCarvill, chief advisor at the NHS Confederation, argues that as we move to more local and neighbourhood working we need to ensure that we harness the power of specialist hospitals that deliver services on a regional, and in some instances, on a national basis.    

Specialist hospitals play a unique and pivotal role in the lives and care of millions of people across England. They have led the way in new approaches and new ways of working, with a particular emphasis on collaboration in the fields of cancer, orthopaedics, neurological conditions, respiratory, burns and reconstruction, bowel, cardiology, children’s health, women’s health and visual impairment. Working at a regional and, in many instances, national level, they provide highly specialist and innovative interventions, pioneering research and new ways of delivering care and support. 

The role of specialist hospitals has most recently been highlighted in a new report – Understanding the performance and potential of specialist hospitals which was commissioned by the Federation of Specialist Hospitals and authored by the Innovation Agency and UCL Health Partners. The report looks at the performance and contribution (actual and potential) of specialist hospitals to the NHS and wider system. 

The report includes a number of recommendations which encourage the NHS to harness the power of specialist hospitals in everything from innovation to workforce development. Most notably it states:

Recommendation: NHS England should consider how specialist hospitals could provide a supportive population health management role in STP work around the standardisation of care pathways and adoption of prevention activities. 

The report and this recommendation in particular is a very timely reminder given the on-going process of developing the NHS long-term plan. The report provides essential bedtime reading for those currently piecing together the plan.   

A key thrust in transformation of health and care is to shift more and more of the focus to what happens at a local and increasingly a neighbourhood level. The ability to shape services that meet the population and need profiles of particular local communities is an important one which will rightly feature heavily in the NHS long-term plan. However, as the focus increasingly shifts to the local, it is important that we do not lose sight of a range of specialist services which are delivered across a much bigger footprint. The risk that as we increasingly focus on what happens locally we forget about those organisations that work regionally and nationally, as well as locally. 

It is vital the NHS plan takes the opportunity to embrace the lessons detailed in the report, to build on the experiences of collaboration to date and to explore the role that specialist hospitals can play in the development of the next phase of system transformation and, in particular, the development of the next phase of sustainability and transformation partnerships (STP) and integrated care systems (ICS). So as the plan is developed it is vital that specialist hospital providers are actively engaged, and their views sought. Theirs is a perspective which is different to other more locally focused commissioners and providers and the services they provide are vital to the workings of the wider system. 

Then, when the plan is published and the focus shifts to the implementation phase, it is equally important that each ICS and developing STP asks itself what role specialist provision plays in the well-being of their local communities? The Innovation Agency and UCL Health Partners report serves as a handy guide for those across the health and care system who will ultimately be charged with implementing the plan. From innovation to collaboration, from sharing expertise to workplace culture, it is all there. While their eyes might be instantly drawn to the local picture, it is also important that they ensure that specialist provision is part of their considerations and wider transformation planning. We should seize this opportunity to answer the age-old question about how we align local planning with the national and regional provision of specialist acute services. This is a conversation that those working in specialist hospitals are certainly up for.

Dr Phil McCarvill is chief advisor at the NHS Confederation. Follow him on Twitter @Phil_McCarvill and the NHS Confederation @nhsconfed

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