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Lord Darzi sets out tough rules for changes in the NHS

Leading clinician and Health Minister Lord Darzi today issued five pledges to the public and staff on how the NHS will handle changes to services. He set out a rigorous process requiring any change to be transparent, clinically evidenced, locally led and for the benefit of patients.

Lord Darzi's report "Leading Local Change" comes ahead of his final report on the next stage of NHS reform.

This new report, aimed at the public, patients and staff, signals that while the NHS must never back away from necessary change to improve services and save lives, there should be important checks which any change has to undergo before it proceeds. PCTs will have a duty to have regard to the following five pledges on change:

  1. Change will always be to the benefit of patients. This means that change will improve the quality of care that patients receive - whether in terms of clinical outcomes, experiences, or safety.
  2. Change will be clinically driven. We will ensure that change is to the benefit of patients by making sure that it is always led by clinicians and based on the best available clinical evidence.
  3. All change will be locally-led. Meeting the challenge of being a universal service means the NHS must meet the different needs of everyone. Universal is not the same as uniform. Different places have different and changing needs - and local needs are best met by local solutions.
  4. You will be involved. The local NHS will involve patients, carers, the public and other key partners. Those affected by proposed changes will have the chance to have their say and offer their contribution. NHS organisations will work openly and collaboratively.
  5. You will see the difference first. Existing services will not be withdrawn until new and better services are available to patients so they can see the difference.

Lord Darzi said: "This is not about change for change's sake. It's about change for the right reasons, improving quality of care for patients and saving lives. These pledges mean change will be locally-led, clinically-driven and evidence-based. And an independent high clinical bar for change should reassure local people everywhere that we mean what we say."

"The right way of doing this is to put local clinicians in the lead, with the public and relevant independent experts consulted and involved at an early stage. Ensuring that changes are based on the strongest clinical evidence and are relevant to their local communities. The role of national bodies has to be to support local clinicians with the best evidence.

"Empowered patients and empowered staff are the key to world-class standards."

Department of Health

What do you think of Lord Darzi's rules for changes? Your comments: (Terms and conditions apply)

"They frighten me to death! We've experienced 'engagement' 'consultation' and 'improvement' and the results do not appear to be empowered patients, empowered staff or an improvement in the quality of service. It has more to do with cuts in service, furious patients and demoralised staff." - Name and address supplied