Reconfiguration of hospital services is “inevitable” if better standards of hospital care are to be achieved, a major Royal College of Physicians report is expected to say.

The RCP will publish the findings of its Future Hospitals Commission on Thursday, making a series of recommendations on how to improve services.

It is likely to back seven day hospital services and increases in the amount of consultant delivered care.

The report is expected to back moves to centralise specialist services and reconfigure hospitals to deliver new models of in-patient care, offering little comfort to smaller district general hospitals.

Patrick Cadigan, the college’s registrar, told HSJ: “For some health economies to provide the kind of high quality care of the sort we will be talking about, such as seven day consultant services as an example, it will mean reconfiguration of services will be inevitable in some circumstances.”

He said these kinds of changes to smaller health economies were “unavoidable” in the long term.

The commission, chaired by Sir Michael Rawlins, the former head of the National Institute for Health and Care Excellence, was set up to examine the current model of hospital care and to recommend changes to ensure “safe, high-quality, sustainable” care continues.

Among the topics it has been focussing on are patient care, the operation of multidisciplinary teams, care pathways, the medical workforce, the use of data and system infrastructure.

A survey of RCP members in February 2012 found over a quarter of consultant physicians rated their hospital’s ability to deliver continuity of care as poor or very poor.

The RCP said when it launched the commission that it had “become increasingly concerned that pressures on hospital services may impact adversely upon the quality of care afforded to inpatients with medical illnesses”.

“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,” it added.

“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.”