What are the different types of NHS hospital?

What are the different types of NHS hospital?

There are 6 main types, all with different roles but working together. We will now go through the 6 different types of NHS hospital.

1. Regional teaching hospitals

Teaching hospitals are usually large and based in or near the centre of a region of the UK – usually in a big city.

They often have 600-1200 beds. They are linked to universities, and usually have a linked medical school. Medical and other health professional students are trained there. They are usually research centres as well.

They usually have the facilities listed in local general hospitals (see below). Those smaller hospitals may act as ‘feeder’ hospitals to them – i.e. transferring patients to the teaching hospital for specialist care.

They also have specialist services for more serious and rarer diseases, like kidney dialysis and transplantation, cancer treatment and plastic surgery. Some have a major trauma centre with a helicopter etc.

2. Local general hospitals

They are usually smaller than regional teaching hospitals. They often have 300-500 beds. They used to be called District General Hospitals (DGHs). Most have a full range of services, e.g.

• Accident and Emergency (A&E) department (usually)
• Outpatient clinics
• X-ray department
• Operating theatres -operations and procedures are done there
• Trauma and orthopaedics
• Procedure units (e.g. endoscopy)
• Medical and surgical wards
• Labour ward, and other Women and Childrens’ services
• Coronary Care Unit (CCU) and Intensive Care Unit (ICU)
• A Walk-in or Urgent Treatment Centre (UTC) or Minor Illness/Injury Unit (MIU).

They are general in the sense that they admit all types of medical and surgical cases; and they concentrate on patients with acute illnesses needing relatively short-term care.

In addition to the medical and surgical services relating to patient care, they will usually have a pharmacy, laboratories, and rehabilitation departments, e.g. physiotherapy and occupational therapy, speech and language therapy (SALT) and dietetics.

Smaller hospitals may diagnose and stabilise patients prior to transfer to such hospitals. They may in turn, diagnose and stabilise patients prior to transfer to teaching hospitals for specialist care.

3. Rehabilitation, community or ‘cottage’ hospitals (even smaller)

They usually have 50 or less beds. Some may specialise in rehabilitation. Traditionally GPs used to run such hospitals. This is less often the case nowadays.

4. Supra-regional hospitals

These cover areas larger than a region. There are two main types:

• • Groups of diseases, e.g. Womens and Childrens, or cancer (Christie in Manchester, Royal Marsden in London)
  • Single organ, e.g. Moorfields Eye Hospital in London.

Sometimes doctors in regional hospitals will discuss a patient’s care with doctors in such hospitals (if the problem is particularly complicated); or even transfer a patient to one of them.

5. Mental health (or psychiatric hospitals)

In the past, these were often in the countryside. Now they are usually in or near 1 or 2. For historical reasons, they are a different part of the NHS than the hospitals above.

So communication is poor between them with doctors being unable to see your medical records from the ‘other one’; and no one knows each others’ email addresses.

6. Private hospitals

There are large companies like Nuffield and BMI that run many of these hospitals in the UK. NHS operations are done in them as well. Again, communication between them and the hospitals above is poor.

Whatever type they are, they are run in a similar way.

Some more information

Hospital Networks and ICSs

Usually 3-5 of the smaller local hospitals are linked to the larger regional hospitals (above) and act together, in what are called ‘networks’. Some patients are transferred on to the regional hospitals; and may be transferred back or go home from there.

Sometimes ambulances will drive past a local hospital if the patient will get better (more specialised) care at the regional hospital – e.g with a stroke, major trauma or burns.

Communication between hospitals

Communication is often poor between the hospitals within these networks, as they are usually different organisations. So they work off different computer systems (and those are different from GPs computers).

It is hoped, over time, that with the development of the new sub-regional NHS organisations called Integrated Care Systems (ICSs), that hospital networks (along with mental health hospitals), will become one organisation (i.e. all part of the same ICS). Then communication should improve.

Summary

We have described the different types of NHS hospital. All are important, and should work together to help you.

Let’s first think about the word ‘hospital’. It is a Middle English word derived from Old French, via the medieval Latin word ‘hospitale’, from the Latin ‘hospitalis’ (meaning hospitable), from Latin ‘hospes’ (host, guest, stranger).