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Clinical Networks

Planning and delivering service changes for patients

NHS England has published a good practice guide for commissioners, to assist clinical commissioning groups (CCGs) should they choose to develop proposals for major service changes and reconfiguration.

CCGs need to consider whether the proposals for service change reflect national and international best clinical practice and can seek the advice of their local strategic clinical networks and clinical senate to determine whether that is the case.

NHS England has also published an effective service change toolkit to assist CCGs.

The decision to request an external clinical assurance review should follow discussions between the relevant commissioner(s) and area teams at the strategic sense check – with input where required from the local clinical senate, who can bring multi-disciplinary strategic advice to the development of proposals.

For relatively small and non-contentious changes, the NHS England assurance stage 1 strategic sense check may conclude a further external clinical assurance is not required. However, where the clinical case for change is more complex, commissioners and senates will be able to draw upon a pool of external reviewers. These reviewers will produce a report for the Clinical Senate. A recommendation will be made by the Clinical Senate, in accordance with its normal process.

The aim of clinical assurance is to establish whether the proposed changes are supported by a clear clinical evidence base and will improve the quality of the service provided.