Specialist Centres To Replace Hospitals

Traditional ‘one size fits all’ hospitals are to be replaced by tightly focused specialist centres which will transform the experience of NHS patients. In a major shake-up of health care, the government will announce that London’s major hospitals will be transformed to focus their work on acute care.

The changes, which will take place over the next decade, will mean two key practical changes for NHS patients. Up to eight specialist stroke centres will be established in London and the number of major trauma centres in the capital will be tripled to handle victims of major incidents and serious car crashes and major incidents.

The dramatic changes will be announced by Professor Sir Ara Darzi, the pioneering surgeon appointed by Gordon Brown as a health minister, who has been conducting a review of healthcare in London. In an interview with The Observer Darzi said that the days of building large new hospitals in London are over.

‘The whole message here is: one hospital that fits all is no longer the future of health service in a big capital city like London,’ he said. ‘I, as a clinician, as a surgeon in cancer, am highly specialised in one area, in one organ. The hospitals are becoming like that, we need more specialised hospitals.’

They will be allowed to focus on acute care by creating up to 200 giant GP surgeries, known as polyclinics, to allow patients to receive all but the most urgent treatment under one roof. Operations under local anaesthetic and treatment for chronic illnesses, such as heart failure, will be carried out at the polyclinics, freeing major hospitals to concentrate on caring for patients with acute needs. ‘A polyclinic is the hub of the community run by our GP colleagues,’ Darzi said of the centres that would employ up to 20 GPs, community consultants and visiting surgeons.

Darzi spoke to The Observer at lunchtime yesterday at St Mary’s Hospital Paddington. Darzi, 47, who made his name pioneering keyhole and robotic surgery for bowel cancer victims, laid down one condition when Brown invited him to become a minister: he will continue to spend every Friday teaching at Imperial College, London, and every Saturday operating at St Mary’s.

At the end of his first full week as a minister – he works four days in Whitehall – Darzi was back on duty at St Mary’s between 7.30am and 2pm. He operated on, or saw, eight different patients. Alan Johnson, the new Health Secretary, will throw his weight behind the Darzi plan when he outlines a new national stroke strategy this week. The surgeon is calling for eight specialist stroke centres to be established in London along the lines of cardiac centres. ‘If you have a stroke and you have a clot you need a CT scan within three hours. If there is a clot you can give that patient a clot busting drug and their chances of survival is significantly better.’

Darzi also wants to see a major increase in the number of major trauma centres, the number of which stands currently at one.