The best configuration of hospital services for Wales : A review of the evidence. ACCESS

Over the life of the NHS, primary, community and hospital services have been subject to continued reorganisation and rationalisation. Often changes reflect developments in medical practice - for example advances in medicine and surgery have driven clinical staff and equipment to become more specialised and have decreased our reliance on bed rest as part of treatment. At the same time, there continues to be strong political and policy pressures to sustain and where possible increase local access to services, particularly those needed in an emergency such as Accident and Emergency services and maternity services. This paper provides a summary of the evidence currently available in relation to access to health care services in the context of hospital care. It aims to inform and support the national and local discussions on the case for change in Wales.