Lord Darzi has pledged to put clinicians at the centre of local decisions to change health services.

In NHS Next Stage Review: leading local change, the junior health minister pre-empts the proposals to be published in regional plans from next week by issuing five pledges to staff and patients on how the NHS will handle changes to services.

As predicted by HSJ, the report promises that change will be transparent, clinically evidenced, locally led and for the benefit of patients, and that existing services will not be withdrawn until patients can see that the new service is better.

The document emphasises that "universal is not the same as uniform", stating: "Different places have different and changing needs - and local needs are best met by local solutions."

The report also states that any proposals for service changes will need to set out the impact they will have on the quality of patient services, including the number of lives saved, risk reduction and health inequalities.

The Department of Health has issued detailed best practice guidance on the report to health managers.

It says strategic health authorities should have a clear and coherent strategy for future service change proposals but that primary care trusts should normally lead the preparation and consultation on service improvements.

Before consultation on service improvements begins, a business case including implementation plans should be set out and reviewed by the SHA.

To download the report, visit nds.coi.gov.uk

Read next week's HSJ for more coverage of Lord Darzi's review.