Trend towards centralisation of hospital services, and its effect on access to care for rural and remote communities in the UK.

There are trends towards centralising hospital care within the NHS, for many excellent reasons. Yet this has a disproportionate impact upon those patients who live at a distance from their hospital, and this impact has not been well reported or researched, but studies have demonstrated that the utilisation of services is inversely related to the distance of the patient from the hospital; so-called 'distance decay'. This article examines the trend and describes the reasons for it, and the impact on those living in remote and rural communities.