The 2023 pre-election period is a week old. Every year when it kicks in, the phones at Stand Towers ring and our inboxes start to ping with quite reasonable questions about what it means and how it should be applied locally. This is the first time Integrated Care Boards have dealt with scheduled elections, so it’s probably not surprising that we’ve had more questions than normal from friends in ICBs about what it means for them and how they should apply the rules.

This year, district council, unitary authority, metropolitan district, and mayoral elections will take place in England on Thursday 4 May.

On 16 March, NHSE issued guidance on the need to observe a “pre-election period”. It states that it should start as soon as formal notice of an election is given locally and in any case no later than 27 March. Ten days might sound like unreasonably short notice of what you have to do in these cases, but the elections aren’t a surprise and the guidance is a reissue of a document first published in its current form in 2019. The expectations are very familiar.

The guidance tells us that “The pre-election period is designed to avoid the actions of public bodies distracting from or having influence on election campaigns.”

What does the guidance mean specifically for NHS service transformation processes?

If you’re in the early stages of talking about the need to change services in an area, we’d be reasonably expected to steer clear of:

•  any activities that could draw attention from the elections,
•  issues that could be picked up by candidates as election issues, and
•  holding or attending events where NHS representatives might be asked to respond to questions on controversial issues.

If you’re planning a consultation or any other public exercise exploring or discussing service change proposals or the need for change, don’t launch it in (or in our view, immediately before) the pre-election period.

If you’re already running a consultation or another exercise to publicly discuss service change proposals, you can continue into the pre-election period. You shouldn’t advertise or promote the exercise until after the election.

Simply put: plan to finish your exercise before the pre-election period.

If your exercise must run into the pre-election period, plan to finish a little while after the election to allow for final chance promotion.

If, for any of the many good reasons to extend an exercise, you need to run into the pre-election period, consider adding the extra time you need after the election.

Don’t publish the outputs of a consultation or other involvement exercise during the pre-election period.

In board meetings, avoid publicly discussing or making decisions on issues that could be controversial.

What does the guidance mean for involvement?

Involvement covers such a wide range of activities that it’s difficult to have a rule. Easier to think of a principle that the NHS doesn’t want to draw local authorities into anything that could be uncomfortable for them, compete with candidates for the public’s attention, or raise issues that could influence or become subject to campaigning in the election.

• Patient experience audits and surveys should be able to continue with no problem.
• Meetings and events that local people can participate in are probably best left until after the election.

There is nuance in how to apply the guidance. Can activity in an area of an ICB footprint where there is no election continue, while activity in another area has to stop?

What happens when urgent service changes are needed in the weeks before an election?

Planned well, the pre-election period is an ideal chance to do the background work needed to launch an involvement exercise, or to analyse and report on the findings of an exercise that’s recently finished.

If you have any questions, we’re here to help. Get in touch like others already have.

Blog by: Paul Parsons
Photo by: John Mounsey