Research into the running and planning of hospital services has been neglected. This is surprising given the importance of hospitals for the public, politicians, and the healthcare system (box (boxB1).B1).
The articles in this series have shown that despite this importance there is a paucity of research and policy about how hospitals work, how they should be staffed, what size they should be, and how change can be managed. This article examines the main gaps in our knowledge about the future of the hospital sector identified in this series and examines the implications of this for policy and research (box (boxB2).B2).
- Hospital planning is done on the basis of limited research
- There is little evaluation of completed plans
- Many of the assumptions used are not stated clearly and are often based on limited or poor evidence—this applies to many of the arguments for increased centralisation
- The paradox of increasing admissions and falling bed numbers has contributed to the problems of responding to emergency care
- Planning needs to take into account the limited state of knowledge