The theme of the Third Hot Topic is "The Centralisation Agenda"

In the UK there are fundamental organisational changes happening with in health services.  Across the UK hospital services are being restructured with a centralisation of acute and specialist hospital services.  In parallel, there is a move to deliver care as close to home as possible.  The rationale is that people should only go to hospital when they absolutely have to and, when this happens, that the transfer should be fast. The hospital stay will be as short as possible with an enhanced care and support package being available in the community on discharge. Care should be provided in the community as far as possible, to avoid hospital admission, and this means developing innovative models to support people in their homes to prevent them going to hospital and / or when they return.

The tension between ease of access and excellence of care is a perennial issue for rural communities.  Rural areas are characterised by their remoteness from acute and specialist care and there is concern that they could be adversely affected by these changes, if hospitals were to become more remote.  Rural populations are ageing faster than those in more urban areas and elderly people have a higher need for care, for example,  in terms of chronic disease.  Together this will impose challenges for rural care providers including the family doctor.  

The questions which we are seeking responses to are:

What is happening in your country in terms of organisation of health services?

Is there a consolidation of hospital services into fewer larger specialist hospitals?  

When making these changes how do policy makers consider the impact on rural practice and rural people?

How do you think that such changes might impact on your practice /  community?

This Hot Topic is now closed and the report will be available in early June.