Website of the Department of Health

Introduction

Keeping the NHS Local sets out new guidance for the NHS on service change. It prescribes the principles and approach that should be applied to all proposals for reconfiguring acute hospitals, with some service models for consultation. This evidence file is first and foremost a tool for NHS organisations considering or undertaking service redesign. It describes how the approaches proposed in Keeping the NHS Local have worked in practice in other health communities. It also describes approaches that have worked less well.

The evidence is organised in two parts:

PART ONE: (the companion document to this) includes reports of clinical trials, service audits and reports of service innovation from peer-reviewed medical journals. It is drawn from international and national sources and varies in its scientific rigour.

PART TWO: (this document) offers examples of service innovation and good practice from the NHS that reflect the principles of Keeping the NHS Local showing what can be done to implement them. Some of the examples have been closely monitored and evaluated. Others are in the early stages of planning and development, but are flagged up as demonstrating the kind of activity in service redesign going on in the NHS. The examples have been divided into six sections:

Some examples fall into several categories. For example, the diagnostic and treatment centres at Stracathro and Central Middlesex Hospitals exemplify ambulatory care at its best but are also examples of imaginative re-organisation of hospital services. Many of the primary care centres like the musculo-skeletal service in Somerset have succeeded by extending the roles of nurses and therapists.