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Clause 118 update could 'disorganise' the NHS

Clause 118 update could 'disorganise' the NHS


Clinical commissioners have complained that changes to the Care Bill could result in a "wholesale re-disorganisation" of the NHS. 

Clause 118 would give a trust special administrator (TSA) new powers to reconfigure services for an entire health economy, allowing fast-track closures to happen to any hospital if there is a struggling hospital nearby. 

The NHS Alliance claim the changes could mean a clinical commissioning group (CCG) that buys services from a successful trust could see them removed, even if they are deemed essential. 

Dr Michael Dixon, chair, NHS Alliance said: “Reconfiguration is terribly important at the present time. But it must have the agreement of local CCGs and local people. Anything less is not fair to either.”

Dr Brian Fisher, GP and NHS Alliance Patient and Public Involvement lead said: "We need to fight against these plans which will enable rapid and virtually unchallengeable reconfiguration across the country, cutting across CCG and public collaboration and involvement.

“Our experience in Lewisham is that the TSA process is dangerous and flawed. A totally new reconfiguration was proposed, beyond any previous suggestions: this made it difficult to explain and respond. It was inaccurately and inadequately described: it left out any mention of the major impacts on paediatric and mental health services. It distorted evidence and statistics. It did not follow agreed procedure: it omitted an equalities impact." 

Dr Steve Kell, co-chair of the NHS Clinical Commissioners leadership group, said: "CCGs have a key role as system leaders and their strong partnership approach with NHS England and local authorities means they are ideally placed to make informed decisions on behalf of their populations."

NHS Clinical Commissioners rejects any proposal which does not take account of the role of CCGs in determining hospital services, their statutory duty to consult populations and their autonomy in making clinically-led decisions.

The British Medical Association (BMA) raised concerns that the original legislation would have "paved the way to backdoor reconfiguration" without taking clinical or local needs into consideration. 

Unlike NHS Clinical Commissioners or NHS Alliance, the BMA believe the changes will put things right. 

Dr Mark Porter, chair of BMA Council, said: "These amendments are a step in the right direction in making sure that staff and managers at neighbouring trusts affected by a TSA recommendation in the future will be properly consulted and their responses considered.

“In the longer term, we recognise that with the NHS under immense strain there is pressure to make changes to the way in which services are delivered. But such changes do not happen in isolation, and it must be recognised that the impact of a Trust Special Administrator investigation on neighbouring trusts affects not only clinicians but can also lead to patient uncertainty, huge cost to the taxpayer and have long-term negative consequences for proper planning of local healthcare services.”



Poor sweet GPs and their CCGs believing they were going to be in charge, on behalf of their patients, and not the government on behalf of privateers - mugged!

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