The hospital of the

futureDr Chris Roseveare

Consultant Physician in Acute Medicine

Immediate Past President, Society for Acute Medicine

@croseveare

The year 2000….

Key priorities for NHS Plan 2000

More staff – and better paid

Faster access to treatment – particularly in A&E

Higher quality of care and cleanliness in hospitals

‘Bring Back Matron….’

Matron returns……….

….and we get a ‘4 hour target’

Dramatic improvements………….

3hrs 45 – 4hrsBut sometimes the target

becomes the target…

2011: A new government:

A new direction….?

Followed by another

change of direction…..

Where are we now?

Overcrowding….a major problem

Slippage……

Where are we going?

The five year forward view….

Focus on Public

Health / Illness

Prevention

Integration of health and

social care budgets Multi-speciality

community

providers

Expand and

develop primary

care

Better Integration of

Emergency Services

£30 Billion Funding Gap by 2021

Action on

Illness

Prevention

Efficiency

savings year on

year

Staged funding

increase

‘as economy allows’

The future hospital commission…..

Established by RCPL 2011

5 work streams and steering group

Extensive patient involvement

Report published 2013

‘There are times when I have felt like

a parcel, passed around the hospital

from ward to ward, sometimes in the

middle of the night’

Co-ordinated care:

‘Chief of Medicine’

‘Acute Care Hub’Continuity of

care as the

‘norm’

Patient experience

valued as much as

clinical

effectiveness

‘Patients do not move wards unless necessary for clinical care’

‘High quality, sustainable care provided 7 days a week’

Rediscover & Value the ‘Generalist’

• Acute Physicians

• Geriatricians

• ‘Dually Accredited Specialists’

Thank you…..

‘The future, according to some scientists, will

be exactly like the past….

…..only far more expensive’

John Sladek