Skip to main content

Lesley Griffiths, Minister for Health and Social Services

First published:
9 May 2012
Last updated:

This was published under the 2011 to 2016 administration of the Welsh Government

In January 2012, the NHS in Wales commissioned Professor Marcus Longley of the Welsh Institute for Health and Social Care to undertake an independent assessment of the evidence on NHS service change, in particular, looking at the best configuration of hospital services for Wales.

The Best Configuration of Hospital Services for Wales reviews the evidence on what constitutes ‘the best’ in hospital provision and assesses the strength and implications of the evidence.  

Professor Longley has completed his work, and presented the findings of this important and pivotal research study to Assembly Members at an event in the Senedd this morning.  

The review concludes that not all patients in Wales are getting the best possible outcomes from their hospital care and there is a strong case for changing the way some hospital services are organised.

Some of the main findings of the report show that:


  • the current configuration of hospital services does not deliver the best outcomes for patients uniformly across Wales;
  • service quality in some areas needs to be improved if Wales is to have services comparable with the best healthcare systems in the world;
  • unless action is taken quickly, the shortage of medical staff in some services is likely to lead to the unplanned closure, and possible collapse, of these services;
  • the increasing specialisation of some types of services means that centralising expert clinical staff leads to better patient outcomes in these specialties;
  • the nature of healthcare means many hospital services are inter-dependent and outcomes for patients could be improved if certain types of services are brought together onto one site; and,
  • the impact of longer travelling distances, as a result of centralisation, can be lessened by boosting pre-hospital care, using telemedicine more widely and effectively and providing better transport links.


I welcome Professor Longley’s work which cements and underpins the case for change.  He has approached this study from a completely independent position and has drawn together the evidence as it is: He has no partisan position to promote.  This report constitutes strong evidence from a clinical perspective – not a political one.

Whilst the aim of The Best Configuration of Hospital Services for Wales is to allow the reader to make up their own mind as to the reasons change is required to the existing pattern of services, it does indicate some key issues the NHS needs to address. It is also a clear reminder the NHS cannot be complacent if it is to achieve the aim of delivering services comparable with the very best in the world.

Professor Longley’s report is written primarily for a lay audience, that is the people who care about the future of health services, people who want to make up their own minds based on the available evidence and between the sometimes conflicting views presented by other sources.  

The focus is on what the evidence suggests about the optimal number, size and distribution of hospital services in Wales.  It is impartial, based solely on the evidence reviewed and any judgements made on the basis of the evidence are explicit.

Following the publication of the report today NHS Wales will be organising a series of regional engagement events presented by Professor Longley, which will allow an opportunity for discussion with local stakeholders around the findings.