New updated guidance on NHS service changes

On 29 March 2018 NHS England published yet more guidance on service change and consultation. 

Planning, assuring and delivering service change for patients: A good practice guide for commissioners on the NHS England assurance process for major service changes and reconfiguration supersedes the December 2013 guidance document (which was revised in October 2015).

The March 2018 document describes the features of a well-run NHS reconfiguration and service change exercise and the steps that NHS England requires commissioners and providers to undertake before any major reconfiguration process is delivered, including effective public involvement. There is a lot of new information contained in this new document.

Organisations, including NHS commissioners, usually CCGs, NHS providers and local authorities grappling with service changes and reconfiguration should read the whole guidance document which sets out the framework for decision-making.

The purpose of the guidance is explained in the Foreword:

“NHS England’s role is to support commissioners and their local partners, including providers, to develop clear, evidence based proposals for service change, and to undertake assurance to ensure they can progress, with due consideration for the government’s four tests of service change and NHS England’s test for proposed bed closures.”

It sets out how new proposals for change are tested through independent review and assurance by NHS England, taking into account the framework of Procurement, Patient Choice and Competition Regulations. The guidance sets out some of the key considerations for commissioners and their partners in designing service change including reconfiguration. Clinical Commissioning Groups (CCGs) are under a statutory duty to have regard to this guidance.

The Five Year Forward View sets out an expectation that, through Sustainability and Transformation Partnerships, clinical commissioners and their partners should think creatively about how service provision could be improved for their local populations and reduce health inequalities.”  

What’s new in the updated guidance

• The executive summary has 20 key messages for commissioners, providers and other interest groups who have a say in NHS changes.
• A more detailed overview of roles and responsibilities for service change looking at:

- what is service change;

- when is consultation with the local authority and public consultation required;

- who is the decision maker around service change; and

- which commissioners should make decisions on service change.   

• Details of NHS England’s assurance process for service change proposals is set out at chapters four and six. There is reference to a toolkit available from NHS England regional teams too. There is also emphasis on the high costs of “getting it wrong”.
• There are a number of helpful Annexes to the guidance document, specifically Annex 4 (which sets out sample questions from NHS England’s Stage 2 Assurance Checkpoint) and Annex 9 (which includes a table of best practice checks that should be undertaken together with details of the tests and example evidence).

Do get in touch if you require support with managing a service change – we have in recent times assisted both providers and commissioners navigate a clear path from inception to implementation.