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The setting up of clinical senates proved how the NHS is being reorganised in a chaotic, reactive manner ; in my area it was given a very low priority by all organisations other than the old SHA because it's remit was confused, poorly thought out and it's authority and lines of accountability were even more vague. The manner that the government/DOH (led by the discredited Dave Nicholson) went about reorganising the NHS is akin to someone randomly taking pieces from several different jigsaws and then trying to put them together in the expectation that they'd fit perfectly and create a clear, understandable new picture. The sooner clinical senates wither away on the vine and consign themselves to history the better.