NHS England has clear guidance on the process for planning significant changes to health services and monitor the process through formal gateway reviews.
Developing the Strategic Clinical Case for Change (STAGE 1)
Our case for change is the first step in this process – identifying the reasons why change needs to happen.
It focuses on the problem of clinical sustainability and recovery of planned care services across our system. Information has been gathered through a range of methods including a review of activity, workforce, finance and performance data; feedback from the clinicians who deliver our services; and initial views from patients and carers using our services.
Development of the case for change involved:
> a review of service data, including workforce numbers, activity levels, performance against clinical standards, finance, patient and staff satisfaction levels;
> clinical workshops, bringing together staff from across both hospital sites to discuss what works well in both services and areas for improvement
> a review of previous patient and public engagement to understand local needs and aspirations for health services; and
> a patient and public listening exercise in early 2022 to assess local views of our services.
Developing Options for the Future (STAGE 2)
Once you establish what needs to change, the next step is to review of how that change can best be delivered.
This involves developing a long-list of ideas and narrowing it down to a short-list of workable proposals for discussion. Our approach will be open-minded, and we will involve a range of stakeholders including the clinicians and staff who deliver our services, patients and carers who access our care, other health providers who refer into our services and system partners such as local authorities and the voluntary sector who support the wider health economy. Working ideas will be published on this website once developed.
The focus is on the benefits that can be delivered for patients by providing high quality care at the right time and in the best place to meet local needs.
Decision Making (STAGE 3)
NHS England has an assurance process for managing complex programmes of service change to ensure that proposals meet the government’s four tests of service change and NHS England’s test for proposed bed closures.
The government’s Four Tests of Service Change are:
- Strong public and patient engagement.
- Consistency with current and prospective need for patient choice.
- Clear, clinical evidence base.
- Support for proposals from clinical commissioners.
In 2017, NHS England introduced a new test for any proposal including plans to significantly reduce hospital bed numbers. This requires systems to provide assurance that their proposals meet at least one of three conditions.
NHS Bed Test
- Strong public and patient engagement.
- Consistency with current and prospective need for patient choice.
- Clear, clinical evidence base.
- Support for proposals from clinical commissioners.