A radical new vision for the ‘future hospital’ has been outlined in a report, which suggests that ‘care should come to the patient’, while patient experience should be considered as important as outcomes.
A new report from the Future Hospital Commission recommends that in future, care should come to the acutely ill patient, rather than the patient being moved around the hospital. This is one of 50 recommendations aimed at improving care for acute medical patients in Future Hospital: Caring for medical patients, which puts the patient experience and the concept of ‘clinician citizenship’ back into the heart of healthcare. According to the report, this should be matched with a radical restructuring of the wards where acutely ill patients are treated, and a new organisational and management structure which stretches out from the hospital into the wider community. The independent Future Hospital Commission was established by the Royal College of Physicians in March 2012 to find solutions to the current challenges facing the NHS – a rising tide of acute admissions, the increasing number of patients who are frail, old, or who have dementia, patients with increasingly complex illnesses, systemic failures of care, poor patient experience, and a medical workforce crisis. Last year, the Royal College of Physician’s report Hospitals on the edge? set out the magnitude and complexity of the challenges facing healthcare staff and the hospitals in which they work – and the potentially catastrophic impact this can have on patient care. It described:
• A health system ill-equipped to cope with the needs of an ageing population with increasingly complex clinical, care and support needs.
• Hospitals struggling to cope with an increase in clinical demand.
• A systematic failure to deliver coordinated, patient-centred care, with patients forced to move between beds, teams and care settings with little communication or information sharing. • Services that struggle to deliver highquality services across seven days, particularly at weekends.
• A looming crisis in the medical workforce, with consultants and medical registrars under increasing pressure, and difficulties recruiting to posts and training schemes that involve general medicine.
In recognition of the need for change, the Commission brought patients and healthcare experts together to develop a vision for the future hospital covering both how patients should be cared for, and the changes in organisation and staffing that would support the new vision. The Commission sought out and benefited from best practice examples of care in England, that are included in the report. The report’s recommendations are centred on the need to design hospital services that are based on the needs of patients, while delivering:
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