Monitor is set to publish an annual “blacklist” of health services which must be reconfigured.
An amendment to the Health Bill, which HSJ understands is to be accepted by the government, will see the regulator identify each year where services are being “put at significant risk by the configuration of [those] health care services”.
The NHS Commissioning Board and clinical commissioning groups in affected areas would also be notified, and have to propose major service changes to solve the problem.
The change is the result of discussions between former health minister Lord Warner and the government. The Labour peer said the law could be used by the commissioning board to ensure CCGs are reconfiguring services where necessary.
The policy is intended to create a “pre-failure regime” under which national organisations can press local health economies into reconfiguring services without providers being put into administration.
Providers that ask for subsidies above standard payment rates – as they are allowed to do under the bill – will automatically be considered for the list.
Lord Warner has been calling for greater pressure on the NHS to reduce hospital services. He told HSJ: “If the commissioning board or CCGs don’t then do anything about it [once they have been notified] they would in effect be failing in their responsibilities.”
He said the government was increasingly recognising the need for major service change, particularly if it wants all trusts to become foundations. He said: “The government [is] beginning to realise what the reality is. Nothing is going to change unless somebody [intervenes].”
He described the list, which would be published by Monitor, as a “blacklist” or “sheet of shame”.
NHS Confederation medical director Hugo Mascie-Taylor said the new process would only be successful if it could “increase the likelihood of identifying the need for service change, or facilitate the change against local opposition and political opposition”.
He said: “Most objection [to reconfiguration] comes from politicians. I’m not clear what extent Monitor reaching its conclusions would influence that process.”
The government also last week said it would accept an amendment from Lord Warner and Baroness Murphy under which the health secretary would be able to order the transfer of NHS funds to local authorities, for example for social care and housing.
This may reflects powers which currently exist, but could have disappeared under the bill.