STRUCTURE: Health bodies in Wales need to centralise swathes of their services if they are to avoid collapse, according to an industry expert.

In a report for the NHS Confederation Wales, author Professor Marcus Longley suggests that widespread centralisation and specialisation in certain areas of medicine are the answer to health institutions’ increasing financial difficulties.

After conducting extensive research into the possible solutions available to NHS officials, professor Longley concluded that the number of both in-patient paediatric units and specialist obstetric practices should be cut.

He also proposed that major trauma units, which deal with patients who have sustained the most serious injuries, could be condensed from local clinics to larger regional centres with more staff and a greater range of medical equipment and capability.

Professor Longley, who works at Glamorgan University’s Welsh Institute for Health and Social Care, wrote in his report that research points to greater survival rates in centralised trauma units.

Writing in the report, professor Longley said: “The case is really quite strong now, in Wales as elsewhere in the UK, that some acute hospital services should now be reconfigured. On the positive side, Wales’ hospitals could provide better care in some key respects, reducing the risks of unnecessary disability and even death.

“More negatively, the pressure on the availability of key medical staff in a small number of specialities is now so great that the collapse of some services is likely.”

In his report, professor Longley was careful to point out that the evidence he found does not always point to a specific answer, and that readers should feel able to draw their own conclusions.