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Reconfiguring Hospital Services: Lessons from South East London considers whether reconfiguration of hospital services is an appropriate response to the need to drive up quality and drive down costs. Based on detailed analysis of proposed reconfiguration in South East London, it draws out important lessons to inform the debate about the merits of reconfiguration of hospital services elsewhere in England.  The conclusions may make uncomfortable reading for policy-makers. Market forces alone are unlikely to result in improvements in quality of care for patients in many hospitals, and could result in deterioration in some cases.  The transfer of commissioning from primary care trusts and strategic health authorities to GP consortia increases the risks of deterioration in quality of care for some patients and a widening of the quality gap between best and worst performers. Reconfiguration that improves quality of care and reduces costs may require consolidation of services across hospital sites. Decisions about reconfiguration will need to weigh the resulting improvements in health care outcomes against the potential costs of reduced competition and choice. Reconfiguring Hospital Services offers a timely and sobering contribution to the emerging debate on how service and organisational change should be taken forward across the NHS in England.[Summary]"],"date_published_tesim":["2011"],"date_published_ssi":"2011","official_url_tesim":["http://www.kingsfund.org.uk/document.rm?id=8972"],"pagination_tesim":["44p."],"place_of_publication_tesim":["London"],"creator_tesim":["The King's Fund","Palmer, Keith"],"date_tesim":["2011"],"date_ssi":"2011","publisher_tesim":["King's Fund"],"subject_tesim":["commissioning","savings","quality improvement","general practice","South East London","costs","hospitals","service delivery","NHS reforms","productivity","NHS reorganisation"],"thumbnail_path_ss":"/downloads/z029p4761?file=thumbnail","suppressed_bsi":false,"actionable_workflow_roles_ssim":["admin_set/default-default-managing","admin_set/default-default-approving","admin_set/default-default-depositing"],"workflow_state_name_ssim":["deposited"],"member_ids_ssim":["z029p4761"],"file_set_ids_ssim":["z029p4761"],"visibility_ssi":"open","admin_set_tesim":["Default Admin Set"],"human_readable_type_tesim":["Published Work"],"read_access_group_ssim":["public"],"edit_access_group_ssim":["admin"],"edit_access_person_ssim":["batchuser@example.com"],"nesting_collection__pathnames_ssim":["000098145"],"nesting_collection__deepest_nested_depth_isi":1,"_version_":1714885499363000320,"timestamp":"2021-10-28T17:30:56.319Z","score":1.0},{"system_create_dtsi":"2021-10-27T22:52:14Z","system_modified_dtsi":"2021-10-28T14:56:34Z","has_model_ssim":["PublishedWork"],"id":"000037715","accessControl_ssim":["83b09481-a551-4722-bb6b-ff4aa7ea8c99"],"hasRelatedMediaFragment_ssim":["3r074t92z"],"hasRelatedImage_ssim":["3r074t92z"],"depositor_ssim":["batchuser@example.com"],"depositor_tesim":["batchuser@example.com"],"title_tesim":["NHS reform :  getting back on track."],"date_uploaded_dtsi":"2021-10-27T22:52:14Z","date_modified_dtsi":"2021-10-28T14:08:33Z","isPartOf_ssim":["admin_set/default"],"biblionumber_tesim":["37715"],"abstract_tesim":["Despite the rapid growth of funding, in 2005/6 NHS trusts in aggregate overspent by more than £1.2 billion, and the NHS as a whole overspent by more than £500 million. More than 60 trusts incurred significant deficits, and turnaround teams were sent in to find out why. Although until recently a key argument for higher NHS spending was a shortage of capacity in the NHS, the press is now full of stories about staff reductions and ward closures. The NHS Confederation warns that the next two years will be 'the most challenging we have ever had to face'. The NHS is widely regarded as being in financial crisis. There is a widespread sense that system transformation is on hold while trusts struggle to maintain or restore short-term financial balance. So, how did we reach this position, and what can be done about it? These are the questions that this paper sets out to answer, focusing on three areas : why is the NHS in financial crisis; how is the NHS likely to respond to recent policy developments; how can the reforms get back on track? [Introduction]"],"date_published_tesim":["2006"],"date_published_ssi":"2006","official_url_tesim":["http://www.kingsfund.org.uk/publications/nhs-reform"],"pagination_tesim":["80p."],"place_of_publication_tesim":["London"],"creator_tesim":["The King's Fund","Palmer, Keith"],"date_tesim":["2006"],"date_ssi":"2006","publisher_tesim":["The King's Fund"],"subject_tesim":["Financing","Policy","Payment by results","Practice based commissioning","NHS reforms","Demand management"],"thumbnail_path_ss":"/downloads/3r074t92z?file=thumbnail","suppressed_bsi":false,"actionable_workflow_roles_ssim":["admin_set/default-default-managing","admin_set/default-default-approving","admin_set/default-default-depositing"],"workflow_state_name_ssim":["deposited"],"member_ids_ssim":["3r074t92z"],"file_set_ids_ssim":["3r074t92z"],"visibility_ssi":"open","admin_set_tesim":["Default Admin Set"],"human_readable_type_tesim":["Published Work"],"read_access_group_ssim":["public"],"edit_access_group_ssim":["admin"],"edit_access_person_ssim":["batchuser@example.com"],"nesting_collection__pathnames_ssim":["000037715"],"nesting_collection__deepest_nested_depth_isi":1,"_version_":1714883805218603008,"timestamp":"2021-10-28T17:04:00.658Z","score":1.0},{"system_create_dtsi":"2021-10-27T22:36:48Z","system_modified_dtsi":"2021-10-28T14:48:07Z","has_model_ssim":["PublishedWork"],"id":"000036533","accessControl_ssim":["0959cc29-5ad5-4b50-b2a3-7fe21fe84628"],"hasRelatedMediaFragment_ssim":["sb3978279"],"hasRelatedImage_ssim":["sb3978279"],"depositor_ssim":["batchuser@example.com"],"depositor_tesim":["batchuser@example.com"],"title_tesim":["How should we deal with hospital failure? :  facing the challenges of the new NHS market."],"date_uploaded_dtsi":"2021-10-27T22:36:48Z","date_modified_dtsi":"2021-10-28T14:02:59Z","isPartOf_ssim":["admin_set/default"],"biblionumber_tesim":["36533"],"abstract_tesim":["One in four NHS trusts in England ended 2004 in deficit. The impact of current NHS reforms will be to magnify financial imbalances at a significant number of trusts, with the risk that some of them will fail. But there is no real plan for dealing with failure in the NHS. This paper outlines proposals for dealing with financial instability by heading off failure before it happens and introducing a regime to manage those failures that cannot be averted. It emphasises the need for mechanisms that not only restore financial viability, but also protect the quality of patient care. [Summary]"],"date_published_tesim":["2005"],"date_published_ssi":"2005","official_url_tesim":["http://www.kingsfund.org.uk/publications/how-should-we-deal-hospital-failure"],"pagination_tesim":["vi, 51p."],"place_of_publication_tesim":["London"],"creator_tesim":["The King's Fund","Palmer, Keith"],"date_tesim":["2005"],"date_ssi":"2005","publisher_tesim":["King's Fund"],"subject_tesim":["Financial problems","Financial losses","Hospital finance","Nhs management","Nhs trusts","Financial management"],"thumbnail_path_ss":"/downloads/sb3978279?file=thumbnail","suppressed_bsi":false,"actionable_workflow_roles_ssim":["admin_set/default-default-managing","admin_set/default-default-approving","admin_set/default-default-depositing"],"workflow_state_name_ssim":["deposited"],"member_ids_ssim":["sb3978279"],"file_set_ids_ssim":["sb3978279"],"visibility_ssi":"open","admin_set_tesim":["Default Admin Set"],"human_readable_type_tesim":["Published Work"],"read_access_group_ssim":["public"],"edit_access_group_ssim":["admin"],"edit_access_person_ssim":["batchuser@example.com"],"nesting_collection__pathnames_ssim":["000036533"],"nesting_collection__deepest_nested_depth_isi":1,"_version_":1714883300483399680,"timestamp":"2021-10-28T16:55:59.305Z","score":1.0}],"facets":[{"name":"creator_sim","items":[{"value":"Palmer, Keith","hits":3,"label":"Palmer, Keith"},{"value":"The King's Fund","hits":3,"label":"The King's Fund"}],"label":"Author"},{"name":"subject_sim","items":[{"value":"NHS reforms","hits":2,"label":"NHS reforms"},{"value":"Demand management","hits":1,"label":"Demand management"},{"value":"Financial losses","hits":1,"label":"Financial losses"},{"value":"Financial management","hits":1,"label":"Financial management"},{"value":"Financial problems","hits":1,"label":"Financial problems"},{"value":"Financing","hits":1,"label":"Financing"}],"label":"Subject"},{"name":"resource_type_sim","items":[],"label":"Resource type"},{"name":"date_range_sim","items":[{"value":"2005","hits":1,"label":"2005"},{"value":"2006","hits":1,"label":"2006"},{"value":"2011","hits":1,"label":"2011"}],"label":"Date Range"},{"name":"file_format_sim","items":[],"label":"File format"},{"name":"member_of_collections_ssim","items":[],"label":"Collection"},{"name":"generic_type_sim","items":[{"value":"Work","hits":3,"label":"Work"}],"label":"Generic Type Sim"}],"pages":{"current_page":1,"next_page":null,"prev_page":null,"total_pages":1,"limit_value":10,"offset_value":0,"total_count":3,"first_page?":true,"last_page?":true}}}