Implementing changes to hospital services: Factors influencing the process and ‘results’ of reconfiguration

Acute hospital reconfiguration is often presented as a problem to be solved by calculations of optimal design, a rational process amenable to influence by open and responsive consultation. The authors aimed to analyse factors in the process and ‘results’ of hospital reconfiguration in three case study sites in the English NHS.

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The authors identified a number of inter-related factors operating in the process of implementation which influenced the ‘results’: 

• the drivers for change, 
• the reconfiguration, 
• its content (particularly the extent to which services are withdrawn or made less accessible), 
• the influence of stakeholders, such as local politicians, financial pressures, and the role of the management team.