Reconfiguration rules held up three months after system reformed
The government has refused to publish guidance which has been prepared on how service reconfiguration could be planned in the new NHS system, more than three months after the reforms took effect.
It comes amid confusion about organisations’ roles in leading major service change.
The Department of Health commissioned a review of guidance on how major service changes should be planned and carried out late last year.
It was carried out by former NHS South West chief executive Sir Ian Carruthers and recommendations were submitted to the DH early this year.
However, it has never been published. An HSJ freedom of information request to the DH for Sir Ian’s review has been rejected.
NHS England said in April it would “develop and oversee a framework” for major reconfigurations, work which was expected to build on Sir Ian’s recommendations.
However, HSJ understands there is no date set for publication of this work, and that it is facing delays.
One senior commissioning source said this was likely to be due to concern it could be seen as a “green light for reconfiguration”, and therefore be politically controversial.
Many NHS leaders have identified the need for major changes to make savings, and confusion in the reformed system about which organisations are able to lead it.
An HSJ survey of 94 CCG leaders in May found 51 per cent believed “CCGs are leaders of [reconfiguration] jointly and equally with each other. NHS England will contribute along with other partners”.
However, 30 per cent said NHS England and CCGs were “joint leaders of the work” and 7 per cent that “NHS England is the convener of the work, with CCGs as partners”. There is also a potential conflict between commissioners’ role and Monitor’s licensing and administration regimes.
NHS Confederation chief executive Mike Farrar told HSJ: “It is really important there is a shared script on service reconfiguration. It there isn’t it is going to hold [change] up even further.
“It would be good for work on this to see the light of day.”
Mr Farrar said the growing transfer of funds from the NHS to social care, “requires resources to be moved from the acute sector into better settings”, which would require major service change.
The DH’s reply to HSJ’s FOI request said: “Sir Ian provided a number of high level recommendations that require further detailed discussions between the [DH] and its partners to translate these into operational practice.
“One of Sir Ian’s recommendations was that, due to the level of organisational change taking place across the system during the final quarter of 2012-13, there should be further detailed work with the new bodies that were formed from April.”