Is it better to travel a few miles to receive better health care – or is it better to have everything close to home? This is a debate raging throughout the NHS and is certainly one of local concern.

We changed the way we deliver services last March and we now provide all acute care on one site. This change inevitably means that some people have to travel further when they are seriously ill, worried about an illness or accident or perhaps are visiting a friend of relative. Is that right?

Of course we would all like the best possible services at the end of our street – world-class specialists, with world-class equipment just around the corner waiting for us to fall ill. Regardless of the affordability of such a system, I don’t think that is feasible. For clinicians to become experts in what they do they need a critical mass of cases, i.e. they need sufficient numbers of patients who need their support so they can remain at the top of their field and further develop their skills. They also need this critical mass to enable them to train the next cohort of expertise.

So let’s agree that acute services (those for patients who are seriously ill and need experts to survive) need to be centrally located. What we must then ensure is that services for those that are less serious – i.e. outpatient appointments, blood and other diagnostics, urgent (but not critical) care should be ‘round the corner’ with limited travel time.

So I apologise to those who have to travel further, but it is in the interests of us all that we have expert care when we need it. Experts save lives – Experts need critical mass to become experts.