Developing alternatives to hospitals

Almost every week we hear a new story of protests concerning the closure of a local hospital.  There is a widespread belief amongst the public that closing hospitals equals removal of healthcare, and of course there are deep concerns about not being able to access the necessary care. However, as Andrew Lansley stated on Radio 4’s Today programme, back in May, “the issue is not whether hospitals close, but how do services best meet the needs of GPs and patients locally in terms of the services they want and their access to services.”

Clearly some interventions still need to be done in hospitals, with specialist consultants available and the necessary equipment to hand.  However recent developments mean that the time we need to spend in hospital is decreasing, and this in turn will decrease the number of hospital beds needed.  Keyhole surgery, and day surgery options, mean that patients can return home quicker, and their condition can continue to be monitored nearer to home.  In addition initiatives to improve the management of long term conditions in the community, spotting and managing exacerbations earlier, will help to cut down on the number of emergency admissions.  One technology which can assist in monitoring of patients, both pre and post hospital admission, is telehealth, a subject on which 2020health will be launching a report, “Healthcare without walls – delivering telehealth at scale” on 24th November.

None of us likes visiting hospital, with its clinical smell, and busy impersonal atmosphere.  What is needed is a diversification of the healthcare system.  A modern healthcare system needs to include a wide variety of options, and possibilities such as health monitoring at home, local health clinics with videoconferencing links to expert consultants and mobile clinics should all be considered.  In addition we need to help people to look after their own health, increasing health education and self-management of conditions.

Since the arrival of the new government, the decisions on hospital closures are to be taken on a more local level, with the views of the local population being taken into account. But those who are anticipating their services being cut, will need to see an alternative before they are happy to let their hospital go.  We need to invest in the development of alternatives before people will be convinced that their hospital really is not necessary, and treatment might be provided better in other ways.