Too many hospital reconfigurations are cost cutting attempts “dressed up as change” which increases public cynicism and damages necessary service evolution, according to the leader of the Royal College of Nursing.
Speaking at the Liberal Democrats conference in Birmingham, RCN general secretary and chief executive Peter Carter said more reconfigurations were necessary but that service changes must be clinically justified.
He highlighted the successful reconfiguration of stroke services in London, which he described as “something truly revolutionary” that was saving hundreds of lives, even though it had been initially been resisted by campaigners.
Mr Carter said: “We at the Royal College of Nursing know the way, the where and how we deliver healthcare has to change and evolve. But one of the things that constantly complicates life, is there are far too many examples of where things are dressed up as change, and wards or A&E departments are closing.
“It is not actually on the back of a good evidence based business case. It’s on some short term saving that will stack up long term problems. That is what confuses the public and embeds the cynicism.”
He added: “So yes to more change, more transparency, properly thought through business cases, a greater narrative with the public and actually a greater narrative with the politicians.
Mr Carter said there were “copious other examples”, like stroke care, of clinically justified reconfigurations.
“But what you need is the narrative, you need to get clinicians on board, you need to get it clinically led. …There’s a cynicism. You’ve got a much better chance of delivering it if it’s clinically led.”
He was speaking at a fringe meeting in the Health Hotel at the Liberal Democrats autumn conference, run jointly by the RCN with the British Medical Association and the Nuffield Trust.
The event asked conference delegates to consider whether they would support an imaginary service reconfiguration, involving the closing of an accident and emergency unit, if they were local GPs and community nurses, hospital doctors, NHS managers, patients and MPs.