Integration – making changes to the way services are delivered

NHS England, CCGs, NHS Trusts and NHS Foundation Trusts all have statutory duties to involve service users and other stakeholders in the development and consideration of proposals for changes to services, where those changes will impact on the manner in which the services will be delivered or the range of services available.

Delivery of more personalised, integrated care for service users under a new care model may well impact on the way in which services are delivered. Engagement will be essential to make the case for change:

Engaging with the public

If changes to services are envisaged it will be important for commissioners and providers to engage with the public early and give them the opportunity to contribute to, and shape, proposals. The public should continue to be involved from the initial proposal stage to the eventual implementation of any new model of care, through the working-up of the options, the testing of the options and the decision-making stage. Depending on the nature of the changes proposed, a formal public consultation may be appropriate

Engaging with local authorities

If a proposed new care model will involve a substantial change in the provision of the health service in a local authority’s area, the local authority will need to be consulted about the proposed changes.

Engaging with NHS England

Early engagement with NHS England will be important as NHS England has developed a process for assuring the development of proposals by CCGs for major service change. The aim of the process is to ensure that there is a consistency of approach in the development of proposals across the country, that proposals are of a high quality and that the process gains the confidence of staff, service users and the wider public. The two stage assurance process includes a strategic sense check (which includes assurance that the four key tests for service change have been met).

Making changes to the way services are delivered – key questions

  • What level of public involvement will your proposed new model of care require?
  • How will you build public involvement into your plans for developing a new model of care?
  • Which organisation will lead on the public involvement process?
  • Do you need to consult the local authority about your proposals?
  • Will your proposals need to be assured by NHS England?

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