Strategic health authorities will be responsible for ensuring there is 'appropriate capability and capacity' in the NHS to deliver 'robust, evidence-based proposals', produce effective consultations and implement changes successfully, Lord Darzi's framework document says.

To do this, they will be expected to ensure that strategies are in place to identify service changes both now and in the future, said guidance accompanying the report. Once plans are developed, the SHAs' role will be even more prominent, as they will be charged with ensuring frameworks are in place to review and test plans to make sure they are appropriate before formal consultation begins.

The guidance also states that SHAs should look out beyond the boundaries of their own regions to ensure any local changes do not undermine the sustainability of the NHS as a whole or impinge negatively on services and patients in neighbouring SHA regions.

They will also be responsible for ensuring that PCT plans adhere to procurement rules and legislation around consultations and issues such as gender equality.

NHS East of England programme director for service reconfiguration Simon Wood said: "There is a much cleaner delineation of our role in that we have to assure ourselves before any consultation starts that we are satisfied that the local health economy has done all the things it should have, that the case... has been through the necessary external reviews and that we support their consultation, before that consultation is launched."