Managers and clinicians are split over whether a review of the NHS will result in major changes to policy.

The review, announced by health secretary Alan Johnson last week, has been broadly welcomed, although there are concerns its aim is unclear.

In his first address to Parliament in his new role, Mr Johnson pledged that the study by junior health minister Professor Sir Ara Darzi would establish 'a vision for the next decade of the health service'.

Not everyone believes the review will lead to a fresh policy direction but many welcome the government's attempt to re-engage the public.

NHS Alliance chief officer Michael Sobanja said: 'I don't think this is about fundamentally changing government policy, I think this is about connecting the NHS and users of the NHS with the reform agenda.

'I think it is the right thing to do but also a tough thing to do.'

Association of Directors of Public Health president Dr Tim Crayford questioned how a greater understanding of the public's wishes would translate into the way services are commissioned and provided.

Time will tell

'Historically, public engagement with NHS reconfigurations has not been great. Can the NHS engage the public more closely on this occasion? We will have wait and see.'

British Medical Association chairman Dr Hamish Meldrum said it welcomed 'the commitment to trust, honesty and respect', but there would be 'widespread cynicism' and it would fail to deliver.

But managers believed the review would bring changes. NHS Confederation policy director Nigel Edwards said: 'They need to do something [as a result of the review]. It won't be enough to say 'everything's fine, it's just a communications problem'.

He warned that the review must remain focused. 'If it's too much of a wide-ranging review, you run the risk of raising expectations that you can't deliver.'

Announcing the review last Wednesday, Mr Johnson promised an end to 'centrally dictated, top-down restructuring' of primary care trusts and strategic health authorities 'for the foreseeable future'.

He also vowed to no longer vet reconfiguration proposals referred by council overview and scrutiny committees. Instead, they will be sent to the independent reconfiguration panel. He added the government will consider the case for an NHS constitution after the review is completed.

Sir Ara is due to report by June 2008, with an initial assessment published in October to inform the comprehensive spending review.

He told HSJ: 'We need to take stock, take a breath and plan for the next 10 years.'

'Take stock, take a breath, plan for the future'

Professor Sir Ara Darzi has been asked to review the following challenges:

  • Working with NHS staff to ensure that clinical decision-making is at the heart of the future of the NHS and the pattern of service delivery.
  • Improving patient care, including high-quality, joined-up services for those suffering long-term or life-threatening conditions, and ensuring patients are treated with dignity in safe, clean environments.
  • Delivering more accessible and more convenient care integrated across primary and secondary providers, reflecting best value for money and offering services in the most appropriate settings for patients.
  • Establishing a vision for the next decade of the health service that is based less on central direction and more on patient control, choice and local accountability and that ensures services are responsive to patients and local communities.