• NHS England to cut clinical reference groups from 71 to 41
  • Charities say loss of CRGs will “dilute” specialist knowledge on rare conditions
  • Anger at NHS England’s decision to advertise posts on newly configured CRGs before publishing outcome of consultation

NHS England has pushed ahead with its plans to cut the number of clinical reference groups, despite warnings from patient groups that the move would reduce the specialist knowledge the NHS has on rare conditions.

The national commissioner has however watered down plans to cut the number of clinical and patient representatives on CRGs.

Brain xray

brain scan xray

Groups such as The Brain Tumour Charity have criticised the CRG cuts

The groups are responsible for advising NHS England on how it spends its £14bn specialised services budget, helping it to develop commissioning policies and service specifications.

In February NHS England set out proposals to reduce the number of groups from 71 to 42 by merging many existing CRGs to create new groups covering multiple services.

It also proposed reducing the clinical membership of the groups from 14 “senate” members to four regional members, and patient representatives from four to two.

NHS England said the changes were aimed at creating “greater alignment of clinical advisory structures” to ensure they were focused on “agreed priorities and addressing the challenges set out in the Five Year Forward View”.

However, charities such as the Cystic Fibrosis Trust, The Brain Tumour Charity and Sarcoma UK said the cuts would “dilute” the specialist advice the health service receives about rare conditions.

While the charities raised their objections in a consultation, the new CRG structure is going to be implemented largely as NHS England intended, with the number of groups cut to 41.

Plans to merge the dermatology and rheumatology CRGs have been dropped, but separate groups planned for ear surgery and ophthalmology have been combined. A proposed specialised orthopaedics group has been axed.

The Cystic Fibrosis Trust said it was “deeply disappointed” by the abolition of the cystic fibrosis CRG “and the manner in which it was taken”.

It said NHS England had “failed to describe how the new arrangements” would maintain or improve the quality of specialist advice on cystic fibrosis.

David Turner, a patient representative on the cystic fibrosis CRG, said it was “extremely frustrating” knowing that specialist advice would be “diminished by these proposals”.

He added: “This is made worse by the wholesale lack of transparency as to NHS England’s motivation for formulating its proposals in the first place, and for dismissing the strong and reasoned objections of consultees.”

Sarah Lindsell, the chief executive of The Brain Tumour Charity, said NHS England had refused “to acknowledge or address adequately the concerns we set out in our response to this consultation”.

“We remain convinced that the decision to disband site specific CRGs such as the one for central nervous system tumours will be detrimental,” she said.

Charities have also reacted angrily to NHS England’s decision to advertise for posts on the newly configured CRGs four days before publishing the outcome of its consultation. Ms Lindsell said the decision was “difficult to understand”.

The criticism echoes a report published on Wednesday by the National Audit Office on specialised services, which said stakeholders had “raised concerns about the lack of transparency in NHS England’s decision making”.

While NHS England is pressing ahead with the CRG cuts, it has watered down its plans to reduce their membership. There will be eight rather than four regional clinical members, and three rather than two patient representatives.

It also said clinical members of some of the new CRGs must have expertise in the condition areas that no longer have their own group.