The South London reconfiguration is happening in a period of change: when CCGs are fully operational, no service reconfiguration should take place without them.
In the new world, the only way that large scale configuration is going to take place is with the full support of CCGs. The new way of doing things is that local area teams will only act in situations like this together with CCGs, along as there is wider support.
The difficulty is that during this period of transition, the decisions are being taken before the CCGs are authorised; we’re in the middle of a period of change. But in the future, the only way we are going to successful in terms of reconfiguration is with the full support of CCGs.
As for trust special administrations, it will be unwise if reconfiguration took place against the wishes of CCGs. Lewisham itself is an unusual situation, because of the transition period. When CCGs are authorised, it would be inconceivable for a trust special administrator, to be set up and take decisons like this.
If the CCGs are against the reconfiguration proposed by the administrators, that causes a real problem – what message are you giving to the public if these bodies are going against the wishes of clinical commissioners?
Dr Charles Alessi is chair of the National Association of Primary Care