Consultation on Substantial Variations and Developments

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Consultation on Substantial Variations and
Developments

• Brenda Cook

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Presentation Summary

• Aims of consultation and involvement
• Summary of duties on NHS bodies to consult and
  involve
• The issue of substantial variations and
  developments
• Ways of identifying what is substantial
• Changes to be implemented in April 2008
• Conclusions

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Aims and outcomes of involvement and consultation

• Aim of patient and public involvement is to place
  patients and the public at the heart of services
• Involvement of individuals and groups or
  communities
• Enable local people to have a role in identifying
  solutions
• Recognise different roles of stakeholders
• Ensure an NHS that is responsive to local need

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Consultation is defined as a dynamic process of
dialogue

• between individuals or groups
• based on a genuine exchange of views, and
• with the objective of influencing decisions,
  policies, or programmes

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Requirements placed on NHS bodies

• Duty to involve and consult patients and the
  public on
• the planning of the provision of services,
• the development and consideration of proposals
  for changes in the way those services are
  provided, and
• decisions to be made by that body affecting the
  operation of those services.
• Duty applies to all service planning and
  decision-making
• not limited to substantial developments

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Requirements placed on NHS bodies

• Applies to NHS body responsible for services
• NHS providers
• NHS commissioners
• NHS services provided by independent contractors
• Includes services provided by independent sector
  on behalf of the NHS

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Consulting on substantial change

• Where proposals for substantial
  development/variation are under consideration,
  NHS must consult with OSCs
• Questions to be considered include
• Will patient services be removed/reduced e.g.
  closure of cottage hospital?
• Is the proposal permanent or temporary, e.g.
  temporary closure of overnight minor injury
  service?
• How many patients will be affected?

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Issues to consider

• Changes in accessibility of services
• Impact of the service on wider community and
  other services
• Number of patients affected, or proportion using
  a service affected
• Budget invested in service
• Methods of service delivery
• Examples from other parts of the country
• What evidence is being used to support proposals?

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Exemptions

• Proposals to establish or dissolve an NHS trust
  or PCT
• Where an NHS body believes that a decision has
  to be taken immediately to address a risk to the
  safety or welfare of patients or staff
• Temporary closure
• BUT
• there should still be discussion with the OSC and
  evidence provided of the reasons for change and
  information about how patients and the public
  have been informed of change.

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Requirements for good consultation

• At a formative stage
• consulting body must have an open mind on outcome
• Sufficient reasons for proposals
• requests for further information
• Adequate time
• usually 12 weeks
• bodies must not delay consultation until
  situation is urgent
• Conscientious consideration of responses
• Effective consultation methods

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Role of OSC

• Define substantial locally with NHS bodies
• Apply locally identified criteria and methods
• Be open about reasons for proposals
• Identify benefits to patients and the public
• Be clear about what involvement and consultation
  has happened during the development of proposals
• Work with NHS bodies to address disagreements
• Refer issues to the Secretary of State for Health

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Changes to be implemented in April 2008

• Local Government and Public Involvement in Health
  Act
• Changes to the duty to involve (s11 H SC Act and
  s 242 NHS Act 2006)
• Requirement on Strategic Health Authorities to
  involve
• Requirement on PCTs to report on consultations
  and how responses influence change
• Establishment of LINks
• No change to powers and duties on substantial
  issues

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Applying requirements and best practice
Planning Involvement of patients and the
public Alert OSC(s)
Proposals Involvement of interested local groups
in identifying proposals and methods of
consultation
Feedback Inform people about the
outcomes Demonstrate how input has been used
Consultation Takes place even when not
substantial Involve stakeholders in identifying
methods Of OSC when substantial
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Thank you

• Brenda Cook
• Consultant and Facilitator
• Tel [phone]
• E mail brenda_at_bcook5.orangehome.co.uk