Much has changed in the hospital sector in recent years.
Hospitals are more open in the way they do business, regulation has increased significantly, access times have fallen dramatically, infrastructure has improved, patient satisfaction has increased, and we have become steadily busier.
There has been a relentless rise in activity, which until recently has been largely matched by funding increases – our now hospitals consume over half of all NHS spending.
The future, however, looks challenging in the extreme.
On the one hand, we know that more effective care must be provided in the community if we are to manage those with chronic illness better.
We know that this will mostly be funded by a reduction in hospital funding. And it has become a widely accepted truism that bed numbers must fall still further as part of this change.
On the other hand, we know that our hospitals are struggling.
A significant number of foundation trusts are in financial difficulty, and others may not be sustainable in the future. Others will not achieve foundation status in their present form.
And all the while, as the Royal College of Physicians pointed out in their important recent report, many are creaking under the strain of emergency demand because the all-important transformation in community-based care has yet to happen.
The solutions to many of these pressures lie in the wider health system, so hospitals cannot solve them in isolation.
For urgent care, in particular, only a collaborative approach will bring about the kind of transformation that we need to see – for the sake of our patients, as well as for economic reasons.
We in the hospital community must therefore be part of the wider debate on issues like limiting the demand for expensive acute care. We cannot sit back and leave all this to others.
We are well placed to help because in hospitals we have teams that are expert in managing long-term conditions. Diabetes, respiratory medicine, care of the elderly, and rheumatology are good examples. These specialists can be deployed more effectively if hospitals take a wider role than they have historically.
Such involvement will enable hospitals to better manage risk and to transform themselves in a measured and managed way that does not tip them into crisis. Hospitals have now come together to launch a new Hospital Forum, a part of the NHS Confederation.
The Forum will not be a special interest group. It will blend the reality of managing in the acute sector with the broader experience and expertise from other parts of the health system, that colleagues within the NHS Confederation will bring.
We aim to be balanced and authoritative. But, above all, we aim to contribute constructively to the significant challenges that we as a health system jointly face.
There cannot be a more important time to speak up for hospitals.
Dr Mark Newbold is chief executive of the Heart of England NHS Foundation Trust and chair of the NHS Confederation’s Hospitals Forum.
He was previously chief executive of Kettering General Hospital NHS Foundation Trust, a post he took up following a 20-year career as a hospital doctor.
Dr Newbold qualified in medicine from Birmingham University in 1983, and completed a research doctorate in 1991. He trained in gastrointestinal disease and histopathology and subsequently practised as a consultant at both Warwick Hospital and University Hospital Coventry.
He played a lead role in developing the National Bowel Cancer Screening Programme and was managing director of Rugby St Cross Hospital before leaving medicine to begin a career as a chief executive. He has particular interests in clinical leadership, patient safety, and public engagement.