Covid-19 reconfiguration: making temporary health service changes permanent

Over the past six months, we have witnessed a wave of Covid-19 health service changes take place across the country. We have also seen clinically-led innovation transforming practice in hospitals from reconfiguration of wards to redeployment of staff within those wards to outpatient appointments set up to run as video clinics. So change is good right?

But deciding which of the temporary service changes should be retained, modified or discarded is not a simple exercise. If the desire is to retain the temporary service change, decision-making will pass to the relevant health commissioner of that service – and with that, a set of high level statutory duties will need to be met before making changes to the way health services are delivered.

In a recent Health Service Journal analysis of key service changes, it suggests that many of these temporary changes are set to remain into next year and could become permanent. It comments that local campaigners are concerned that these changes may not be reversed, such as the downgrading of certain A&E services without public consultation.

However, NHS England has made clear in its response that: “Any proposal by local clinicians to make permanent changes to services will continue to require the appropriate level of engagement and consultation.”

So, whether you are a commissioner or provider looking to make a small or substantial service change you will need to comply with your statutory duties and the range of detailed guidance, including NHS England’s 2018 guidance: Planning, Assuring and Delivering Service Change for Patients.

Reconfiguration of clinical services continues to generate controversy both locally and nationally. It involves politics with a “p” and a “P”.  Many argue that Covid-19 represents a catalyst for long-planned change and, given the significant financial constraints and workforce challenges, pressure to reconfigure services is only like to increase.

It is therefore important that the right steps are taken at the right time to deliver a lawful reconfiguration scheme and avoid both the delay and expense of a judicial review.

Do get in touch if you would like to discuss any of these issues or require support with managing your service reconfiguration – we have assisted both providers and commissioners to navigate a clear path from inception to implementation.

We also have a series of detailed briefings on this topic which we will be happy to send to you, so do drop us an email or give us a call.

Jill Mason and Samuel Lindsay 

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