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Reconfiguration must stop being a ‘dirty word’

NHS managers and the medical Royal Colleges have called for a radical rethink of the way hospital reconfigurations are carried out, with the NHS overcoming its ‘paralysis in relation to change’.

The NHS Confederation, Academy of Royal Colleges, and health and social care charities have jointly published a report describing six principles for local leaders in reconfiguring services.

The report, called Changing care, improving quality, follows the NHS Confederation’s annual survey of its members which showed that 53% thought difficulty in communicating the need for change to the public is a substantial barrier to successful reconfiguration or redesign of services.

The report argues that patients must be engaged from the beginning - rather than just via a formal consultation - and that a clinically-driven case for change must be established to motivate clinicians.

Plans should also be developed in partnership with staff, who should be regularly updated about progress and given the opportunity to put forward their ideas.

The report says: ‘Reconfiguration, the term often used to describe large-scale changes in healthcare, has increasingly become associated with making cuts and downgrading services.

‘It is also more commonly associated with changes to health services that have been triggered and driven  by a financial or clinical crisis.

As such, the act of transforming how we deliver care is regarded by many as a threat to the services people rely on.’

Mike Farrar, chief executive of the NHS Confederation, said: ‘More than two-thirds of NHS Confederation members have told us “political resistance” is the biggest barrier they face in relation to successful service reconfiguration. But political courage by itself is not enough to deliver the kind of change that the NHS needs at this point in its life; the service itself must overcome its paralysis in relation to change, and it must bring the right people with it.

‘The onus is on us in the NHS to build the case for change amongst the people we need support from, so that “reconfiguration” stops being a dirty word and starts to represent the kind of planned, well-evidenced change programme which the NHS deserves.’

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