Technocracy or politics? The process of hospital reconfiguration. Perri 6, Nottingham Trent University and Naomi Fulop, King’s College London. Defining “reconfiguration”.
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Perri 6, Nottingham Trent University
Naomi Fulop, King’s College London
a deliberately induced, non-trivial change in the distribution of medical, surgical, diagnostic and ancillary specialties that are available in each hospital or other secondary or tertiary acute care unit in a locality, region or health care administrative area
Specialist routine elective unit
Telemedicine: digital imaging relay, videoconferencing, CfH, care pathway monitoring
Extended roles for nurses and for non-medical staff: nurse-led clinics, pre-op assessment, prescribing
Ambulatory care incl. One-stop elective day surgery, diagnostics, dermatology
Dedicated routine maternity unit, e.g. midwife-led
Hospital at night programmes: some generic medical roles, senior nurse coordinators
“Networks” (all over again?)Examples of DH approved reconfiguration initiatives
Popularly measured Technically measured
Clinical professional institutes
StHAs, some PCTs, Health economists
InputWho wants what?
Consumer: service goals
Patient: health gain goals
Taxpayer: value for money goals
Voter: accountability goals