Quick guide: How to plan for NHS service reconfiguration

1. Ensure that you embed public involvement into all stages of your commissioning processes

Remember that patients and the public should be involved in the planning and development of proposals – not just handed them to consider at the consultation stage.

2. Review your published commissioning policies and processes

Are they clear? Could the average man or woman in the street read them and understand when, why and how they will be able to get involved in your commissioning work, when you will consult and when you will otherwise engage with the public? 

3. Remember the strategic and financial context

Commissioners should pay regard to Joint Strategic Needs Assessments (JSNA) and Joint Health and Wellbeing Strategies (JHWS)and keep a record of how they have done so. The Assurance Process will focus on affordability and deliverability, so keep these points well in mind from the start. 

4. Keep your Local Authority Overview and Scrutiny function well informed of your plans at an early stage

Don’t just wait until you are about to consult – early engagement can flush out where opposition is likely to arise which can give you the time to modify plans; explain them; or just get ready to stand your ground! If you surprise your Local Authority with a potentially contentious proposal, you are greatly increasing the risks of a dispute and a referral to the Secretary of State. 

5. Proposals should have clinical leadership and involvement from the very outset

The 2015 NHS England guidance emphasises this. Clinical involvement from the outset will boost your chances of demonstrating compliance with the four tests, and also increase the credibility of your proposals in the public’s eyes. 

6. Engage with NHS England from the outset of considering a significant reconfiguration

Getting through the NHS England Assurance Process is an absolute must. While “passing” the assurance process is not strictly a legal requirement, it is likely to be very difficult to implement changes that are actively opposed by NHS England. Trying to do so would also increase the chances of a legal challenge from dissatisfied patients and/or the local authority. Assurance is no “tick-box” exercise. We have advised clients who were fully expecting to pass and found that NHS England was not satisfied with their proposals. Getting an early understanding of what NHS England expect and when they expect it will reduce your chances of hitting the same problems.

If you found this guide helpful, you might be interested in our more comprehensive briefing. Get in touch to request a copy.