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“Leading Local Change” (NHS Next Stage Review)

Volume 475: debated on Friday 9 May 2008

In my oral statement of 10 October 2007, Official Report, column 297, I notified the House that my noble Friend Lord Darzi had published an interim report as part of the NHS Next Stage Review. I am writing to update the House on the progress of the review as Lord Darzi has today published “Leading Local Change”.

The Prime Minister and I asked Lord Darzi to lead the review in July 2007. His interim report in October set out a vision for a world class NHS that is fair, personal, effective and safe.

The review has been led locally by clinicians in each NHS region. Seventy-four local clinical working groups, made up of some 2,000 clinicians, have been looking at the clinical evidence and engaging with their local communities. They have developed improved models of care for their regions to ensure that the NHS is up to date with the latest clinical developments and is able to meet changing needs and expectations.

Lord Darzi is today publishing “Leading Local Change” to set the context for these local visions and the principles which will guide their implementation. We are also publishing new operational guidance, as promised in October’s interim report, to help ensure that any changes are based on clinical evidence and are in the best interest of patients. As part of this, we are making five pledges on change in the NHS, which primary care trusts will have a duty to have regard to:

change will always be to the benefit of patients. This means that they will improve the quality of care that patients receive—whether in terms of clinical outcomes, experiences, or safety;

change will be clinically driven. We will ensure that change is to the benefit of patients by making sure that it is always led by clinicians and based on the best available clinical evidence;

all change will be locally-led. Meeting the challenge of being a universal service means the NHS must meet the different needs of everyone. Universal is not the same as uniform. Different places have different and changing needs—and local needs are best met by local solutions;

local communities will be involved. The local NHS will involve patients, carers, the public and other key partners. Those affected by proposed changes will have the chance to have their say and offer their contribution. NHS organisations will work openly and collaboratively; and

local communities will see the difference first. Existing services will not be withdrawn until new and better services are available to patients so they can see the difference.

The nine strategic health authorities (SHAs) outside London will be publishing their strategic visions for improving health and healthcare in their regions over the coming weeks in accordance with the following timetable.

The SHA strategic visions will be published as follows:

12 May

East of England

14 May

Yorkshire and Humber

15 May

South West

19 May

South Central

20 May

North West

22 May

North East

2 June

South East Coast

3 June

West Midlands

5 June

East Midlands

Lord Darzi will publish his final report in June. It will be designed to enable and support the improvements that have been determined locally in the SHA strategic visions.

I firmly believe that this approach, led by clinicians, based on clinical evidence and strong engagement with local communities, is how changes to the NHS should take place as we move from an NHS that is world class in many aspects to one which is world class in everything it does.