That we are more than halfway through the general election will be welcome news to many. If the outcome of the election is clear and a government is formed quickly, we can look forward to NHS England’s pre-election guidance being lifted straight away and the business of patient involvement and public consultation resuming.
Over the years NHS England appears to have taken an evermore cautious approach to these restrictions and one of my mini professional frustrations of the election being called is that there will be another inevitable delay in the promised publication of an update to the PADS service change guidance.
For those of us working in service change Planning, assuring and delivering service change for patients (PADS) is the go to document. It’s our script, our framework and our guide. I make no secret of how good I think different aspects of the document are. I’m a long-term fan.
But no matter how solid the fundamentals of the document are, the reality is PADS is woefully out of date. Published in May 2018 the main document refers to Sustainability and Transformation Partnerships, NHS Improvement, the Five Year Forward View, and CCGs. The references to legislation are mostly outdated and some important legal changes aren’t reflected. The addendum issued in 2022 takes account of the big capital projects in the new hospitals programme and leaves many other questions open.
Whispers on the grapevine have told us an update is imminent for some time. We expected an update in July 2022 after the implementation of the Health and Care Act. We waited in 2023 as several opportunities passed with no news. An update could have followed soon after this year’s January publication of regulations for the secretary of state’s new intervention powers and to update the health scrutiny rules. It could have happened at the end of the financial year as it has before, or followed the local authority elections. Now it will be July at the earliest and given summer breaks possibly not until even later in the year.
Why am I bothered, you might ask? After all, my colleagues and I get to keep working with a document and process we know inside out and back to front. The world has moved on since 2018 and some of the known shortcomings that have developed in PADS are becoming like old friends. Without an update, a brilliant document (to my mind one of the best guidance documents NHS England has produced) loses relevance and credibility.
I’m looking forward to the new PADS including more on acceptable or expected approaches to developing proposals for changes to services. I’m looking forward to greater regulatory clarity on the process where urgent changes to services are required on a temporary basis. I’m looking forward to seeing greater prominence for health equity and environmental considerations in service change programmes. And I’m looking forward to newer clients being able to read and understand the document without a guide to the institutions and documents of NHS past.
So while I love the cut and thrust of political debate in a general election, there’s a professional part of me that can’t wait for it all to be over, so at least there’s a chance that the next version of PADS will drop into my inbox. I promise to share my excitement with you all when that happens.
Blog by: Paul Parsons