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Local power over health changes urged

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A plan to give the NHS Commissioning Board an “active role” in the reorganisation of local health services is “in tension” with a pledge that power will be transferred to local organisations, Solace has warned.

The group has welcomed a commitment in the Department of Health’s mandate to the NHSCB that clinical commissioning groups (CCGs) will be free to set their priorities based on local needs.

However, it has raised concerns about a statement in the mandate that the NHSCB - a national body with regional arms - will sometimes “lead work to redesign services that it commissions, or support groups of CCGs in handling complex or large-scale service changes.”

Such changes could include the closure of hospitals or hospital services, which would prove controversial locally.

In its response to a consultation on the mandate, Solace said giving this role to a national body was “held in tension with” encouraging the transfer of power to local groups.

It said: “Service redesign should be locally determined, with maximum flexibility for local partners to deliver against priority outcomes. The mandate should explicitly open the way for varying arrangements at local level based on outcomes delivery.”

The response also said the mandate should “place a greater emphasis on the NHSCB working with partners, in particular local government, to tackle the wider social determinants of health and health inequalities, such as housing, unemployment, access to leisure facilities, the environment etc.”

It said plans by the DH to introduce a “choice framework” that would set out the choices patients would be entitled to make “could have the unintended consequences of raising expectations at a time when the health sector and its partners are finding it difficult to meet existing demand.”


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