Reconfiguring clinical services: what’s the evidence?


Dr Zoe Wyrko is a Consultant Geriatrician at University Hospital Birmingham and Current British Geriatrics Society Director of Workforce Planning. She tweets @geri_baby. Here she tells us about how the latest King’s Fund paper is relevant to geriatricians.

On Tuesday, the King’s Fund published a new paper called ‘The reconfiguration of clinical services – what is the evidence?’ in which they consider the drivers and evidence base behind the constant push for change which is endemic within the NHS. The authors discuss an analysis carried out by the National Clinical Assessment Team, commissioned by the National Institute for Health Research, and its implications for the National Health Service.

The document confirms what many of us working on the ground have probably suspected for some time: there is no evidence that reconfiguring hospital services on financial grounds alone produces a positive impact, but it does expose organisations to distraction together with clinical and financial risks. There is mixed evidence as to whether reconfiguration with the aim of improving quality is beneficial, with the most positive results found when such changes are carried out related to specialised services. This is clearly highly relevant to us as geriatricians, who are most likely to lead change for this reason.

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