In many ways, the passing of the Health and Care Act in 2022 feels both a moment and a life time ago.
In that time we have seen Integrated Care Systems formally established, Integrated Care Boards and Integrated Care Partnerships formalised, and systems operating – and beginning to think – in much larger footprints, while managing place-based and neighbourhood relationships.
Many parts of the Health and Care Act are still to be enacted, though, including regulations that will introduce new elements to programmes of major service change and amend existing scrutiny powers.
Anyone with experience in delivering service change will agree that a comprehensive understanding of the associated legal duties is paramount to success. This includes the powers that local authorities have to scrutinise proposals.
As part of the process of implementing these new regulations, the Government has been clear that local authority Health Overview Scrutiny Committees and Joint Overview Scrutiny Committees will no longer be able to formally refer service change proposals to the Secretary of State.
Instead, the Secretary of State will have the power to ‘call in’ proposals for change and make recommendations. So what does this new ‘call in’ power mean for the role of local government in major service change?
Well, the answer isn’t clear to anyone yet. For twenty years, local authorities have been able to use their referral power to ensure that proposals for major service change are rigorously scrutinised. Losing this ability will be a big change. Some fear that scrutiny committee members will be less able to effectively represent the interests of their residents in discussions about NHS services in their area because of it. What is certain is that some things will have to change to make sure local authorities still play an active and meaningful role in scrutinising these services.
So what does this mean for the new and changing face of collaboration between commissioners, providers, and their local authority colleagues?
We know one thing: the new regulation requiring commissioners to notify the Secretary of State of proposals for major service change means that ambitions for change will be clear, clearly set, and importantly – public.
This could be an opportunity for local authorities and commissioners to work more closely together at the early stages of a service change to identify and agree common priorities before proposals are made public through the notification duty.
The best change programmes don’t engage with local authority scrutiny because it’s the law; they do it because they know that working in partnership with local government is effective, supportive, and drives positive change. Commissioners and local authorities have a strong, shared knowledge of the patients and the public that they serve. Sharing that knowledge in constructive ways bolsters the benefits of the changes that are being proposed.
With solid shared plans, and cards on the table from the point of notification, NHS organisations could work collectively and collaboratively with their local government partners towards a vision for better services that improve how patients and the public access health and social care in the future.
Will this change work to meaningfully develop the relationship between NHS bodies and local government? And will the removal of the referral power delegitimise the role of local authorities, or serve to give them greater opportunity to get involved at earlier stages?
These are questions we’re looking forward to seeing play out, as well as supporting, once the regulations come into force some time in the new year.
Note: we love to talk about all things service change. For an informal conversation about the details of these new regulations, get in touch with us at hello@wearestand.co.uk.
Blog by: Jonny Williams
Check out our bonus episode on our podcast, Not a Consultation where we discuss these changes further and how they might affect service change programmes. We’ve got some tips for managing what’s coming too.
