As health and healthcare change, hospitals inevitably need to respond and adapt. However, hospitals are popular local institutions, and implementing changes can be politically difficult.

This project focuses on the objectives and the process of hospital change. We are interested in why and how hospitals should change. It is for local decision-makers to work out the details of local health service provision – the ‘what’ of the future hospital. At present, in part because of the political barriers to change, the NHS is not achieving the best outcomes from reconfiguration in terms of improving quality and access to services. Nor is it maintaining public trust and confidence in the process of change. This situation needs to be reversed if the NHS is going to succeed for future generations.

This paper sets out the objectives for hospital change that a progressive health system should aim to achieve.