Abstract

Changing patterns of disease have led to an over-reliance on specialists, yet there is a lack of coordination of clinicians with specialist expertise, as well as an increasing disease burden on society. Issues of poor quality care and unsafe environments, too, are never far from the headlines, and are symptomatic of a systematic breakdown in care.

Healthcare in the 21st century needs to look beyond the four walls of the traditional hospital and become a more agile, dynamic and fluid service focused around a patient type increasingly likely to present multiple, chronic health problems.

Patients in the 21st century require a holistic approach to meeting all their clinical, care and support needs. They need collaboration at all levels and across all sectors, including health, social care, housing and local government.

Medical care and support teams should be organised around the needs of patients. Specialist care needs to be delivered closer to home and beyond the walls of the hospital. And to provide a continuity of care, the role of generalists will not only need to change but be valued as much as specialists.

In an effort to put this thinking into practice, the RCP, in 2012, established a Future Hospital Committee to deliver a programme and policy context underpinning an agenda for transformation. Following the committee’s report in 2013, four development sites were launched to explore future hospital and new care model concepts. Three of the four development sites are focused around improving care of frail older patients, while the fourth aims to streamline the care of patients admitted via acute medical admissions services.

Ian will update the congress on the Future Hospital programme and provide insight on the lessons for evolving and refining the concept of the hospital without walls to deliver holistic and coordinated care for patients, whether they are in hospital or in the community.