TY - JOUR T1 - Why bigger isn’t always better: Caring for patients in smaller, rural and remote hospitals JF - Future Healthcare Journal JO - Future Healthc J SP - 4 LP - 5 DO - 10.7861/fhj.ed-7-1-2 VL - 7 IS - 1 AU - Louella Vaughan Y1 - 2020/02/01 UR - http://www.rcpjournals.org/content/7/1/4.abstract N2 - One of the current obsessions of the NHS is with economies of scale – the notion that healthcare would be safer, faster, cheaper and more efficient if services were provided by larger teams in bigger hospitals or across ever-enlarging networks of organisations. This could be seen as an extension, albeit in a mutated form, of the decades-long drive towards centralisation and specialisation of hospital services.1,2 To these ends, over half of all hospitals in England have been closed or merged in the last 20 years, while one of the purposes of sustainability and transformation partnerships (STPs) is to create unprecedented economies of scale at regional level across every type of NHS organisation.2–4One of the consequences of this trend has been to make the smaller hospital seem a near irrelevance in the NHS landscape. Yet smaller hospitals provide care to nearly half the … ER -