Carruthers seeks to 'raise the bar' for reconfiguration referrals

NHS South of England chief executive Sir Ian Carruthers told councillors at a Local Government Association meeting last week that it was “inadequate” for local authority scrutiny committees to oppose NHS shake-ups in their area on the grounds that they “don’t like it”.

Sir Ian was asked by NHS chief Sir David Nicholson in the autumn to carry out a review of the NHS reconfiguration process.

He said at the meeting he was likely to recommend a new system in which objections to proposed reorganisations had to provide evidence that the plans did not meet “tests” in four areas: safety, patient choice and engagement, clinical evidence, and support from clinical commissioning groups.

Councils have the power to refer proposed NHS changes to the secretary of state, and ask for the schemes to be reconsidered. Sir Ian said it was likely that in future these referrals would “need to be made in the form of a statement that meets each of the tests”.

“To simply write and say ‘we don’t like it’ or ‘it’s not what we think should happen’ will be inadequate”, he said.

“I know every scrutiny committee would say, we provide fantastic evidence, but I’m not sure that is actually so.

“If you did an analysis of every letter received, some are extremely full of evidence and others less so. I think we need to be honest about it”.

He added that he wanted to “raise the bar” so that standards of evidence used in these cases would be “higher and more convincing”.

Meanwhile, Sir Ian was also criticised at the meeting for telling councillors that the presence of a journalist meant he was “limited in what I can say”.

Steve Bedser, a Labour councillor and cabinet member for health and wellbeing at Birmingham City Council, told him: “The fact that you feel constrained because this is a public meeting is a small illustration of the bumpiness of the road ahead [as councils take on responsibility for public health].

“I think people [in the NHS] will find it culturally very difficult to understand the dynamics of a health and wellbeing board that is democratically accountable and held in public. To manage disagreements in anything other than a transparent and public way would be untoward.”