The Future Hospital Commission, chaired by Professor Sir Michael Rawlins, aims to address growing concerns about the standards of care currently seen in hospitals and to make recommendations to provide patients with the safe, high-quality, sustainable care that they deserve.

The Commission will examine organisational structures, processes and standards of care, focusing on five key areas:

• patients and compassion: leadership, responsibility and compassion on the wards and the operation on multidisciplinary teams
• place and process: patient pathway and the balance between generalist and specialist care
• people: composition and development of the medical workforce, and interaction between medical and other teams
• data for improvement: use of patient records, medical information and audit
• planning infrastructure: organisation of diagnostic, support and community services.

The Commission will involve professionals from across health and social care. Patients will be involved throughout the work of the Commission. The Commission will present its final report to the RCP president and Council in 2013.

Why has the RCP set up the Future Hospital Commission?

All hospital inpatients deserve to receive safe, high quality, sustainable care. It is increasingly clear that we must radically review the organisation of hospital care if the health service is to meet the challenge of rising acute admissions, an ageing population and an increasing number of patients with complex, multiple conditions. Hospitals also need to continue to adapt in order to take advantage of new technologies, drugs and innovations, cope with pressures on budgets and staffing and respond to the changes introduced by the Health and Social Care Act 2012.

The RCP has become increasingly concerned that pressures on hospital services may impact adversely upon the quality of care afforded to inpatients with medical illnesses. This affects hospitals’ ability to deliver:

• high quality care sustainable 24 hours a day, 7 days a week
• continuity of care as the norm
• stable medical teams for patient care and education
• optimised relationships with other teams
• appropriate balance between care by specialists and generalists
• discharge arrangements which realistically allocate responsibility for further action

This has been a recurring concern in the RCP’s discussions with doctors at a local level, with our committees and our patient and carer network. A survey of RCP fellows and members found that over a quarter (28%) of consultant physicians rated their hospital’s ability to deliver continuity of care as poor or very poor. The results reinforce our concerns about the increasing pressures faced by NHS trusts due to the rise in acute admissions, the ageing population with increasingly complex conditions, and cuts in budgets and staffing.