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The healthcare sector must identify new models of care for patients and come up with creative ways to address the scale challenges facing smaller hospitals, a new report by regulator Monitor has recommended (13 June).

Following a review on the effect the size of an organisation – acute providers – has on performance, the regulator found no clear evidence that smaller acute hospitals perform worse clinically than larger counterparts.

'Greater financial challenges'

As such, Monitor has recommended that the health sector: 

'Stop obsessing'

Commenting on the report, NHS Confederation chief executive, Rob Webster, said: “This important report provides additional weight to the view that we need to stop obsessing about the size of organisations and start thinking much more about models of care. 

"Small hospitals have a future as part of a whole-system approach to healthcare. Along with everyone else, small hospitals will have to adapt the range of services that they provide, and the ways in which they do so, as they continue to be part of the offer of local access to healthcare."

'One size will not fit all'

Mr Webster went on to say: “The 2015 Challenge Declaration, published by the NHS Confederation on behalf of a broad partnership, provides a helpful backdrop to this work. A key element of this approach is that one size will not fit all. 

"Local communities need the freedom and flexibility to find the right solutions for their local populations’ health needs.

'No significant correlation'

“The evidence... shows no significant correlation between quality of care, size and financial viability, based on a sample of assessed small providers," he said. 

"This endorses the view that new models of care – rather than different structures to deliver such care – are now required by the system.

“Ultimately, we need to ensure that the 21st century patient receives ongoing support and care in the right place and at the right time to deliver the best outcomes.”