Patient groups wary of ‘fast track’ NHS reconfigurations

Both Labour and the Conservatives have said they want all trusts to achieve foundation status - almost certainly requiring takeovers and major reconfiguration - and Labour is also understood to be considering a “fast track” process as an incentive for foundation trusts to take over other trusts.

Foundation trusts have called for the government to make it easier to close services where it will improve quality and efficiency.

But patient representative experts warn a fast track process would probably involve changing the legal requirement to consult on large service changes, or councillors’ legal right to have them reviewed.

Sally Brearley, King’s College London senior fellow in public and patient involvement, said it was difficult to see how public involvement could be maintained and guaranteed if those legal requirements were reduced. She said involvement was necessary to make sure changes were in the public interest.

The umbrella patient group National Voices has acknowledged significant and controversial changes, including hospital closure, will “sometimes be the right outcome”.

But chief executive Jeremy Taylor urged caution when changing consultation rules: “Fast tracking is great if it cuts out bureaucracy and allows changes to be brought forward which will benefit patients.”

But he added: “It is also a recipe for eroding public confidence if it allows vested interests to get their way with minimum scrutiny.”

Last week health secretary Andy Burnham said he would halt plans to close the accident and emergency department at the Whittington Hospital in London, after it became the focus of fierce campaigning in the run-up to the election.

However, the heads of 13 medical colleges and associations and NHS Confederation medical director Hugo Mascie-Taylor last week called for “large scale planned service redesign and reconfiguration based on clinical evidence”, including closure of A&E departments, children’s services and surgical units.