Junior health minister Lord Darzi has pledged not to 'tinker' with the tools of reform as part of his Next Stage review of the NHS.

Lord Darzi, who has been making visits across the NHS, told HSJ his focus would be more clinical.

'The message that I'm getting is that all the tools we have in the system at the moment are the right reform tools to achieve the right ends, but we need to reform some of our clinical models of care.'

Some staff were concerned the review would 'start tinkering with some of those tools' he said. 'We reassured them that is not the purpose.'

Lord Darzi said strategic health authorities will be asked to set up working groups chaired by 'clinical champions' to feed into his final report, due in July next year. The groups are expected to begin meeting in October.

'Each of those working groups in the 10 strategic health authorities need to engage with the user, the public and clinical colleagues to capture issues challenging the health economy at a local level,' he said.

'We can't start [the national debate] until we capture what the issues are from the bottom up and address those at a national level.'

Lord Darzi said there would also be national consultation through meetings with staff and the public on 'big themes' including safety, training, clinical leadership and the NHS constitution.

There will also be two or three national meetings for staff from different professional backgrounds to feed into the review.

Lord Darzi is expected to file an interim report in late September to inform the following month's comprehensive spending review.

The final review will also help 'establish a clear strategy for the next decade of the health service', the DoH said in an outline response to its damning capability review by the Cabinet Office. A final response will be published in September, two months later than promised (see 'DoH misses deadline as it fails to deliver own turnaround plan').

The interim response sets out improvements to be in place by January including: setting out the DoH's role clearly for all staff; running courses to improve policy development and advice to ministers; and a 'talent management programme'.

Lord Darzi hit out at Conservative leader David Cameron's assertion at the weekend that the peer believes 'district general hospitals are over' following his review of the NHS in London.

Lord Darzi said: 'Hospitals in the future will have all sorts of different roles, there will be dramatic change. That is not a closure and I don't know how you can interpret it as a closure.'

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