Health Minister Karl-Josef Laumann, together with the North Rhine-Westphalia Hospital Association, the North Rhine-Westphalian Medical Associations, and representatives of the statutory health insurance funds, presented the key elements of the draft of the new hospital plan for North Rhine-Westphalia. The goal of the new hospital plan is to ensure innovative, quality-oriented, needs-based, and comprehensive inpatient care for all citizens in North Rhine-Westphalia – from metropolitan regions to rural areas – through particularly efficient structures.

>> Since the end of 2019, the State Committee for Hospital Planning, under the leadership of the Ministry of Labor, Health and Social Affairs, has developed the basic principles for a new hospital plan in around 50 working group meetings. The results of these meetings were presented to the full committee at the last committee meeting. The starting point for the development were the findings of the expert report (1) presented by Health Minister Laumann in 2019, as well as the status report (2) analyzing the hospital landscape in North Rhine-Westphalia, commissioned by NRW Health Minister Laumann and prepared by "PD - Berater der öffentlichen Hand GmbH" in cooperation with "Lohfert & Lohfert AG" and the Department of Health Management at the Technical University of Berlin.
The key findings of the report:
• tendency towards medical oversupply in urban areas
• partial undersupply in rural areas of the country
• Number of beds as a central planning basis prevents targeted control of capacities
• Inpatient care is not sufficiently focused on the quality of treatment.

"We are moving forward boldly in North Rhine-Westphalia," said NRW Health Minister Karl-Josef Laumann, visibly proud of becoming the first federal state to plan its hospital structure "differentiated across service areas and service groups." The new hospital plan is intended to introduce a differentiated planning system that combines effective management, transparency, and quality. In the future, so-called service areas and service groups will be identified, reflecting medical specialties and sub-disciplines. The new planning system also introduces uniform and verifiable quality standards for each care offering for all hospitals. And most importantly, hospital planning will no longer be based primarily on the "rigid plan size of bed," as was previously the case, but will instead be based on the actual caseloads in the various service areas. This will ensure that hospital planning is more closely aligned with actual care provision than before.
The new hospital plan also incorporates the experiences of the coronavirus pandemic: Nationwide primary care will be strengthened. In North Rhine-Westphalia, over 90 percent of the population is to be able to reach a hospital within 20 minutes by car. The plan also stipulates the nationwide provision of intensive care. In the future, pulmonology departments, which played a special role during the pandemic, will also be included in the hospital plan again.
The final consultation on the new hospital plan will take place in the State Committee for Hospital Planning. Following this, the draft of the new plan will be presented to the State Parliament's Committee for Labor, Health, and Social Affairs in the fall. The new hospital plan can then enter into force, after which the state government aims to initiate the necessary regional planning procedures at the beginning of next year.
"With the new hospital planning, I want to achieve the best possible quality in inpatient care," Laumann said, setting the tone, with the new structures focusing on patients. Hospitals, Laumann continued, must, of course, be easily accessible for everyone. However, specializations are also necessary. "People rightly expect that a hospital has sufficient experience and guarantees a high quality of care when offering a specific service. This is precisely what we want to ensure for the future, and this is what the new hospital planning should ensure." However, this requires a "careful redesign with balance and balance."
"In our view, the current draft of the hospital plan proves that the questions surrounding a future healthcare structure can be most effectively answered at the federal states and in the regions," emphasizes Jochen Brink, President of the North Rhine-Westphalia Hospital Association (KGNW). The task now is to implement the new planning system with a sense of proportion and a realistic view of regional structures. "The goal must remain to ensure today's reliable, local, and high-quality healthcare," says Brink. To ensure local acceptance of potential impacts, all decision-making processes must be made transparent.
"Well-positioned hospitals are a central and indispensable component of public services and thus of our community," said Dr. Hans-Albert Gehle, President of the Westphalia-Lippe Medical Association. He welcomes the fact that future hospital planning will be more detailed than before. "Medicine has evolved and specialized. The medical associations have responded to this development with new continuing education qualifications. The future hospital plan, with broad service areas on the one hand and specialized service groups on the other, also moves in precisely this direction and provides a sensible framework within which the regional planning concepts will then be developed."
Gehle believes it is particularly important that regional hospital planning promotes cooperation between hospitals: “Cooperation instead of competition. Meaningful special
Specialization in mutual agreement instead of everyone doing everything! This is precisely what is in the interest of patients. According to Gehle, the new hospital plan provides a basis for reconciling basic care close to home on the one hand and sensible specialization on the other, especially at the regional level. However, this hospital planning should not be "undermined by false funding incentives at the federal level and irrelevant specifications from the Joint Committee on Health." Gehle: "Because hospitals that meet demand must also have a sufficient financial basis."
Rudolf Henke, President of the North Rhine Medical Association, welcomes the fundamental direction of the new hospital planning in North Rhine-Westphalia. "In our view, the medical quality of hospital care depends crucially on adequately staffing departments with properly qualified physicians. This will only be possible in the future if high-quality medical training remains possible even with increasing specialization." Therefore, the Medical Association welcomes the draft's alignment of hospital planning with the Medical Training Regulations and advocates for "mandatory establishment of continuing education networks between specialized and standard care locations."
"The new hospital planning in North Rhine-Westphalia will initiate the urgently needed turnaround and create the right conditions for a sustainable, quality- and patient-oriented hospital structure in the state that will enhance the quality of treatment and optimize the use of resources," says Tom Ackermann. Patients must be able to trust that treatment is provided "only where the best possible conditions exist."
"Not every hospital does everything equally well," adds Matthias Mohrmann, board member of AOK Rheinland/Hamburg. Experts are aware of this and can respond accordingly. Medical laypeople, on the other hand, rely on reliable support. Mohrmann: "For them, it is necessary that hospital planning in the future makes quality the benchmark. This will change the focus of care and the roles of many hospitals." Nevertheless, comprehensive care remains "an immovable cornerstone, especially in rural areas."