Understanding Approaches to Service Reconfiguration
The NHS Long Term Plan signalled a major shift away from acute care to an increased focus on preventative care in the community, led by Integrated Care Systems and founded on the development of local Primary Care Networks, to address changing population needs. Whilst many improvements will be incremental, in some systems, more major service change (often called ‘reconfiguration’) may be required to fulfil the aims of local plans and to make services safer, more sustainable and improve population health.
In November 2019 NHS England and NHS Improvement (NHSEI) commissioned SQW (with support from the King’s Fund Library Service) to examine the approaches that health and care systems across England currently take when planning and delivering reconfiguration schemes. The research ran until May 2020, and the findings and outputs of this research will help NHSEI to understand what it can do to better facilitate and support reconfiguration.
Over 110 in-depth interviews were undertaken with national, regional and local stakeholders involved in delivering and/or overseeing reconfiguration, alongside a review of existing NHS guidance and published international evidence on reconfiguration. SQW explored practises and processes in eight reconfiguration schemes, including a specialised commissioning scheme and others including A&E, maternity, stroke and mental health services.
The research highlighted good practise in informing and planning reconfiguration, exploring all stages from pre-consultation and early engagement, all the way through consultation to full business case development, implementation and evaluation. It also highlighted key challenges and learning points, followed by a series of recommendations for systems considering or embarking upon major service change / reconfiguration.