Wednesday 13:20
Sir Ian Carruthers, Chief Executive of NHS South West today outlined recommendations around the process of reconfiguration in a letter sent to Chief Executive of the NHS, David Nicholson.
Sir Ian Carruthers was commissioned in October 2006 to conduct a short review of the systems and processes around service improvement in the NHS. This advice will be conveyed to all Chief Executives of Strategic Health Authorities, who are responsible for the reconfigurations within each region.
Welcoming the review, Chief Executive of the NHS, David Nicholson said:
'The NHS has always changed and adapted to new technologies and patient expectations and must continue to do so. The recommendations from Sir Ian's work are not a signal to propose more or less service change. It is for Chief Executives of local NHS organisations to consider what is best for their local NHS patients and carers and sometimes difficult decisions have to be made to ensure that services are sustainable in the medium to long term. However, the NHS can and must do better in how we make these decisions, from establishing the evidence base and case for change, through to having proper implementation plans with clear benefits for patients and timetables for delivery. Sir Ian's work provides us with a real opportunity to raise the bar and learn from the best in the NHS, so that the NHS can continue to evolve and adapt to the needs of all patients and be fit for purpose in the 21st century.'
Sir Ian Carruthers said:
"Change can all too frequently lead to a loss of public confidence in service providers if the process is not managed carefully, and stakeholders are not fully engaged as early as possible. The goal of any change to services must be to ensure patients get the best care possible, delivered to the highest standards in the most effective, efficient and personalised way. It must not be change for the sake of change. It is in the interests of everyone to ensure that reconfigurations are carefully and robustly planned and managed. It is right that decisions about our hospitals and healthcare are closely examined and questioned, but it is vital that changes are made to ensure safe and effective clinical practice is available to all."
The main recommendations in the review are:
* Reasons for change need to be clear and well articulated; the case for any change needs to be stronger. Recent Tsar reports make it clear that major service changes are first and foremost about saving lives
* Clinical and staff involvement in developing proposals is critical; we need greater engagement of clinicians, staff and their representatives in the process at a local, regional and national level
* Good preparation and understanding the process (pre-consultation, consultation and implementation) is crucial; there is a wide variation in quality & fitness of proposals
* Strong coherence and co-ordination of local proposals is essential. Some areas have clear strategies, in others the approach has less cohesion. PCTs should be at the centre of major service change, driving service improvement where appropriate
* SHAs should use the "Service Improvement Readiness Framework" to ensure that proposals for change are sufficiently robust and fit for purpose
* Gateways and thresholds should be put in place locally to ensure applied minimum standards are met
* Communications need to be strengthened; consultation documents should contain specific, relevant, clear information written in plain English for local stakeholders to comment in an informed way on local proposals
* Systems will be put in place by each SHA to ensure that the process of reconfiguration and consultation is open, transparent and well managed
* New leadership teams need to review inherited schemes, and assure the Department of Health that they are fit for purpose, whilst ensuring that they work with local stakeholders - consulting, listening and involving them in their local NHS
Notes to Editors
1. Sir Ian Carruthers is Chief Executive of NHS South West. He took the position of interim Chief Executive of the NHS for six months in 2006. He was asked to conduct a review in to the process of reconfiguration in October 2006.
2. The final paper from Sir Ian Carruthers was presented to the NHS Management Board today. This can be found on the DH website at http://www.dh.gov.uk
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