Darzi report reveals service change plans

  • Published: 09 May 2008 09:30
  • Last Updated: 09 May 2008 10:51
  • Reader Responses  
NHS Next Stage Review: leading local change

NHS Next Stage Review: leading local change

Lord Darzi has pledged to put clinicians at the centre of local decisions to change health services.

In NHS Next Stage Review: leading local change, the junior health minister pre-empts the proposals to be published in regional plans from next week by issuing five pledges to staff and patients on how the NHS will handle changes to services.

As predicted by HSJ, the report promises that change will be transparent, clinically evidenced, locally led and for the benefit of patients, and that existing services will not be withdrawn until patients can see that the new service is better.

"Different places have different and changing needs - and local needs are best met by local solutions"


The document emphasises that "universal is not the same as uniform", stating: "Different places have different and changing needs - and local needs are best met by local solutions."

The report also states that any proposals for service changes will need to set out the impact they will have on the quality of patient services, including the number of lives saved, risk reduction and health inequalities.

The Department of Health has issued detailed best practice guidance on the report to health managers.  

It says strategic health authorities should have a clear and coherent strategy for future service change proposals but that primary care trusts should normally lead the preparation and consultation on service improvements.

Before consultation on service improvements begins, a business case including implementation plans should be set out and reviewed by the SHA.

To download the report, visit nds.coi.gov.uk

Read next week's HSJ for more coverage of Lord Darzi's review.


Please note: In order to post a response you need to be registered on the site. You can register here.

Reader Response

Hmmm
Clinician-led, local patient focussed....
I seem to remember this is what Alan Milburn said about primary care groups and PCTs some years ago. it didn't happen then even though there was a funding increase which could have enabled it. Instead resources soaked away into the combined sands of management consultancy and payment by results. And the present top down direction will really be the last one? Ho ho ho.

are you all saying our current system is a good one? There are many patients getting a poor service.

This all sounds very plausible, but in effect means services run on a shoestring by personnel who are not properly trained or renumerated (and I'm not talking about clinical staff here, but those on the frontline who have to bear the brunt of patient services daily) and the value of which is dubious. Already NHS Confederation policy director Nigel Edwards is getting his managerial oar in and instead of these proposals saving the NHS money (which was the original intention) is already looking at doubling the cost of providing these services! I very much hope these proposals are shelved before they do any lasting damage. Divisive, double-speak and cheap is my verdict so far.

Well put.

I wish I could believe him - but recent government actions don't give me much hope.
Recently we have had the introduction of both new surgeries in "under-doctored" areas, and Polyclinics in every PCT regardless of need and withno suggestion of clinical - or managerial - input!
In Luton - next door to my PCT - it looks as though they will have to have both a new APMS GP practice (no local tendering) *and* a new Polyclinic: they already have a Walk-in Centre.
Is this what Lord Darzi means? Clinician led from the House of Lords? Patient demand from no 10 Downing Street?
And if local patients, clinicians and managers see no need, does he mean we can refuse to have Polyclinics?