Hospital of the Future: a framing paper

Following Reform’s papers on structural reform, Close enough to care, and primary care, Prescription for Prevention, Hospital of the Future takes this work forward by proposing a fundamental reset in the approach to secondary care.

Policymakers have paid lip service to prevention for decades, but realising this ambition will be unachievable without a coherent plan for the role of hospitals.

However, even without the Government’s commitment to shift to prevention, the issues facing the secondary care model are pressing. Rising costs, falling productivity and performance, declining access and deteriorating patient satisfaction are all symptoms of a profound problem.

The diagnosis of these symptoms reveals deeply structural and cultural problems. Rather than being an issue of more staff or money, these challenges arise from a mix of issues including a poor understanding of how patients flow through the hospital, internal fragmentation, external isolation and chronic inefficiency. The long-term prognosis is similarly damning: costs are rising, demand is changing, and prevention could in fact destabilise hospitals.

But it is not all bleak: this paper diagnoses the problem, ahead of subsequent papers that will methodically explore how to reimagine hospitals for the modern era.