zlacker

The distinction is important because they are what makes the scale manageable, and it also provides resilience.

Though it also leads to inconsistency and the "postcode lottery" problem where the quality of treatment a patient receives for a specific condition can be extremely variable depending on where they live.

>>Silhou+(OP)
That's true, but now mitigated at least to some extent by the right to choose (though people are woefully unaware of this, and GP's in my experience never ask so you need to bring it up if you have issues with your local hospital - the NHS could do better at requiring this; in some cases I've been given links to pick treatment provider after being referred, and it'd be nice if that was the norm).

But it's better to have management failings contained to individual trusts, that are monitored, than to have these failing affect the system as a whole. Not least because it does allow patients going elsewhere as a last resorts.