South West Clinical Senate. Principles for Developing Community Reconfiguration Proposals (Nov 2016)
As Sustainability and Transformation Plans (STPs) are being developed across the 6 STP footprints in
the South West, the Clinical Senate is increasingly being asked to provide independent clinical review
of plans for community transformation.
The Senate can give clinical advice to the 11 CCGs in the South West both as an early advice giver
and more formally as part of the NHS England stage 2 assurance checkpoint which considers
whether proposals for large scale service change meet the Department of Health’s 4 tests for service
change prior to going ahead to public consultation. The Senate considers test 3, the evidence base
for the clinical model as an independent clinical advice giving body.
There have been some key themes running through Senate advice on the topic of community
transformation and reconfiguration to date, both in the South West and elsewhere across England.
The South West Clinical Senate along with other Senates has commonly noted concerns around
workforce as a key example. Many Senates have also found that the documentation submitted to
describe the clinical model can be extremely lengthy, yet at the same time not highlighting
sufficiently some of the key facts and detail around development.
It was therefore considered that it would be beneficial to develop some general principles for
community reconfiguration that CCGs and STPs could refer to when developing models of care. It is
intended that the Senate could then review community reconfiguration proposals by exception
where the following principles are not met, making the test 3 review process less onerous whilst also
sharing key learning and research from around the country.
The following principles have been developed based on previous Senate advice, clinical reviews
already undertaken in the South West, reviews undertaken by other Clinical Senates, the findings of
a literature review considering the evidence for community reconfiguration and the findings from
the Clinical Senate session on 10th November 2016.