Tomorrow junior health minister Lord Darzi releases another part of his next stage review. It demonstrates some deft political footwork.
The report is billed as a "framing document". One of its aims is to defuse the sensitive issue of service reconfiguration. He hopes to neutralise any "save our hospital" protests by making the reconfiguration process clinically, not managerially, led. If you cannot demonstrate your redesign will save lives or improve outcomes, don't bother. There is a touch of mea culpa by the government in this, admitting that changes to services have been pushed through without providing robust clinical arguments justifying the upheaval.
And by tackling reconfiguration in advance of the final report, the Department of Health minimises the risk of it distracting attention from the rest of the review.
The framing document will also make clear an important change of emphasis in the Darzi process. In recent months it has been hard to turn in the NHS without bumping into someone involved in a strand of Darzi research. The volume and breadth of material heading towards the DH raised fears about the practicality - never mind the desirability - of central government attempting to synthesise this into one, coherent Grand Plan.
The framing document is expected to shift the emphasis of the review decisively towards the plans each strategic health authority has drawn up for its area. Lord Darzi's final report will now focus more on what government can do to support these regional plans, such as giving clinicians and managers more freedom.
The next stage review has the best chance of success if it is built on locally determined change, not national prescription. The signs are promising.