Published by the Institute for Public Policy Research (ippr) the focus of this report is on the politics and process of hospital change at a local level. This is based on a year-long project that began with desk-based research, a research seminar and meetings with stakeholders and experts. A theoretical framework was developed to explore the local politics of hospital change, generating a series of hypotheses about the preferences of different stakeholders. These hypotheses were then tested and explored in two case studies of recent hospital reconfigurations, where 28 local stakeholders were interviewed. These included: managers and clinicians working in the hospitals, primary care trusts and strategic health authorities involved in change; local patients; public groups including hospital campaigners; and local politicians, including councillors and MPs. (ippr - press release)