title: Organisation of acute general hospital services: a surgical synopsis of the JCC document.
abstract: Hospital networks should be created, where possible by amalgamation into larger Trusts sufficient to provide comprehensive acute services to a population base of 450,000-500,000. In many areas, however, DGHs serving 200,000-300,000 will remain the backbone of the NHS and will provide the majority of acute services, although specific arrangements with neighbouring units will need to be made for a range of sub-specialties, such as vascular surgery. Where distance dictates the need for isolated small hospitals to continue to offer acute care, close professional links should be established with larger units so that patient care without compromise in quality can be offered even though transfer may be necessary. Because such hospitals may find it difficult to meet the new European Directive on the 48-hour working week for both permanent staff and junior doctors, staffing arrangements both at consultant and junior level might have to be very different from those expected in larger hospitals. There will need to be a major increase in the number of consultants in almost all surgical specialties.
authors.forename: C
authors.initials: C
authors.lastname: Collins
mesh_terms: D000208:Acute Disease; D002648:Child; D002662:Child Health Services / Q000458:organization & administration; D013502:General Surgery / Q000458:organization & administration*; D006769:Hospitals, General / Q000458:organization & administration*; D006801:Humans; D006113:United Kingdom