The Future Hospital Commission has recommended a radical re-structuring of care for frail elderly people with complex needs. There is a need to avoid multiple moves for patients with multiple morbidities after their admission to hospital. Instead of moving patients between specialist hospital wards, the plan is for consultants to move around more flexibly, and thereby to take care to the patient. Generalist wards would become more common. Closer working with teams in the community after hospital discharge is also recommended.
The Commission recommends the creation of a new “hub” in each hospital, called a Clinical Coordination Centre (CCC), to act as a central control room, ensuring information about patients is shared between specialists, and patient-centred care is planned properly.
The concept of hospitals discharging patients may become replaced by an ethos of ongoing care. Consultant visits to people in their own homes, or in community outreach centres, after discharge could become more common. In practice, planning for post-hospital care should commence at the point when someone is admitted to hospital.
The report recommends a focus on patient experience, principles of patient care, communication and accountability. Patients should be treated with kindness, respect and dignity. They should be fully involved in decision-making about their care, with more emphasis on support for self-care, autonomy and prevention of ill-health.
The patient (and family / carer) should know who is responsible for their care, seven days a week, with a named consultant working with the nurse ward manager. Patients treated by multiple specialists should have their care coordinated by a single doctor.
Continuity of care should be the norm, with access to similar services at weekends as on weekdays. Specialist medical teams would work with partners in primary and social care to support patients outside hospital. A new Medical Division in each hospital, caring for medical patients, should have care responsibilities extending outside the hospital into the broader health community.
Examples of best practice in care are supplied in the report.
Triggle, N. (2013). NHS patients ‘should not face constant moves’. London: BBC Health News, September 12th 2013.
“The Future Hospital Commission, set up by the Royal College of Physicians, says it wants an end to patients being moved around between wards, and much more flexible working from hospital doctors”.
Read more and view the short video: BBC News. Overhaul of hospital care urged.
Jeffreys, B. (2013). Overhaul of hospital care urged. London: BBC Health News, September 12th 2013.
This relates to:
Future Hospital Commission (2013). Future hospital: caring for medical patients. A report from the Future Hospital Commission to the Royal College of Physicians. London: Royal College of Physicians, September 2013.
There is also an Executive Summary.
Supporting RCP documentation is listed below:
[A brief reference to this item features in Dementia: the Latest Evidence Newsletter, Volume 3 Issue 10, September 2013].