In a week of heart wrenching stories from Ukraine filling our social feeds, a little nugget of NHSEI (NHS England and NHS Improvement) news was enough to bring a little light into my day.

That news? The NHSEI system transformation team launched a new interactive handbook for service change.

Granted, the list of people this news will bring joy to is a short one, but for this dyed-in-the-wool service change anorak, any new document on health service change is exciting.

Major Service Change: an interactive handbook sets out in 83 pages the context and process of service change in twelve easy-to-read sections. Together they chart the course and requirements of a service change programme. And it links directly to an enormous resource of secondary documents in a whole new indexed resource on Future NHS (*if you’re not a member, sign up).

So what’s new? Well firstly, it’s important to point out what’s not new: all the current guidance and law stands. And the 2018 planning, assuring and delivering service change for patients (PADS) takes pride of place in the handbook’s main list of key resources. Of course we’re proud to see the guide on legal duties for service change, Caroline and I wrote with Capsticks for NHS England in 2020, also on that shortlist. The handbook explains it’s written in February 2022 based on legislation and guidance that applies now. The introduction acknowledges there will be changes when the Health and Care Bill becomes law, so we can be pretty sure there’s an update draft already waiting in the wings for publication in a few months’ time.

The most obvious development strikes as you click on the index. An introduction and eleven stages of service change that expands the six-stage summary process that’s illustrated in PADS, and we’ve relied on as the basis of our plans for years. 

The first of these stages is ‘Drivers and context’, which points to the rigour needed to give your change programme a solid start. Including an important message to start by developing a solid understanding of the situation and challenges. Every change programme has a starting point and the handbook encourages us to know where we are now in detail, before we start working out where we should put our new Hyper Acute Stroke Unit, how many Urgent Treatment Centres we need, or whatever other change programme we are working on.

The handbook helpfully splits the NHS assurance process out into its three stages and sets them out at the relevant points in the process. This means readers get a much more accessible explanation of the requirements of each assurance point than has been available before. That’s going to be incredibly useful to people who are coming to service change for the first time.

Proposal development and options appraisal approaches are under ever increasing scrutiny from the public and local politicians, and we’re given much more detail about these than we’ve had before. And by setting out an eight-month process for planning, preparing, delivering and reporting on a public consultation, the document gives change programme planners a handy and, I’d argue, reasonable insert for their timelines. This gives me hope we’ll see fewer programme timelines arriving on communications and engagement colleagues’ desks with a three-month non-negotiable window to do everything.

Each section of the handbook treats us to an impressive bank of helpful documents. There are case studies, example cases for change documents, webinars, example pre-consultation and decision-making business cases, slide decks on important aspects of the process, and we’re given links to external web-based resources. 

All in all it gives us more than 1200 pages of additional documents, that together look uncannily similar to our own resource library. On top of the legal duties guide in the key resources section, we’re pleased to see a webinar Caroline and I did for the transformation team in October 2019 on planning and conducting a public consultation included in the public consultation section.

And among these hundreds and hundreds of pages, it’s nice to see the return of some old favourites like the previously underused and under promoted Toolkit for communications and engagement teams in service change programmes, which by mishap or design seemed to have disappeared from the public website in 2019.

Inside the sections, I have a few questions about some of the drafting choices that I’ll pick up with the team. And a concern or two that the very accessible language and layout might mean some programme leaders less familiar with these processes might underestimate some of the requirements. These are minor points. 

Overall the document is a triumph. It’s clear to see the effort and commitment that’s gone into developing the handbook. It’s a huge achievement. It shows in one place the complexity involved in running a service change programme and the breadth of the considerations that need to be taken into account. It will be invaluable to change programme leaders across the country including the service change programmes Stand supports.

Congratulations to the transformation team and everyone involved in bringing this together at NHSEI. It will be a game-changing resource.

Oh, and the handbook tells us an addendum to PADS will be published shortly, so brace yourself for more excitement from Stand Towers!

Blog by: Paul Parsons