In a recent announcement by the Health Secretary, Andrew Lansley, the formation of clinical senates will play a key role in advising on major service changes as part of the government’s NHS Reform.

The formation of senates consisting of doctors and nurses – of whom there are expected to be between 14 and 20 senates, will cover wide regions of England. Under the government’s proposed plan, the senates will advise commissioning groups, doctors and the NHS Commissioning Board on “major service changes” and also whether local plans are “clinically robust.”

Under the proposed formation of senates, around 20 to 30 NHS hospitals in England may have to re-evaluate and re-shape their operations to ensure they are able to remain financially viable. The array of changes includes: the loss of blue light accident and emergency departments, the concentration of maternity, paediatric and other services on fewer sites. 

With possible closures and merges of hospitals across the UK, could lead to further job losses within the NHS such as doctors, GPs, GP Locums and nurses, despite the government’s promise to protect the health service. 

Mr Lansley’s proposal of the formation of senates will hopefully provide clinical as opposed to political justification for what could be unpopular closures and service relocations. 

In addition to the formation of senates, the department of health plans to introduce a new duty on local authority scrutiny committees. The scrutiny committees will be able to make challenges to any changes in services and to ensure both quality and finances are taken into account before any changes are made or appealed. 

Professor Steve Field, who chaired the group of 45 independent experts on the NHS Forum, which advised the government, said, “The service must grasp the nettle of reconfiguration.”

“That would be difficult and unpopular and mean fewer hospitals as care was moved outside them. But clinicians had to make the case for that in order to produce better and safer services.”

However, despite the government’s attempt to show more support for any changes based on clinical expertise, the formation of senates could see a rise in the number of bodies being formed before any changes to services can be agreed. At the latest count, these would include clinical senates, clinical networks, patients, health and well-being boards, council scrutiny committees; the patients group HealthWatch and more.

Chris Ham, chief executive of the King’s Fund health think-tank, said, “The results was a ‘Health Robinson’ creation which will create a traffic jam that will make change very difficult. It will be slow, bureaucratic system in which everyone has to be consulted by everybody at every point in time.” 

Furthermore, the proposed paper also highlights the power that will be vested in the new quango, the commissioning board. The quango is believed to need at least 3,500 staff and initially around 50 offices across England in varying sizes so that it can indeed carry out commissioning where GP commissioning groups are not ready to do so. 

With the creation of another quango and commissioning groups will inevitably create more bureaucratic wastage on resources at a time when the government is trying to implement financial restraint to the NHS. With further wastage on layers of bureaucrats, it is this money critics would argue could be better spent on recruiting more doctors, GPs, GP Locums and nurse jobs across the NHS. 

Since the government’s announcement to the independent review of the NHS Reform Bill just over a week ago, it appears that the government has listened to and acted to the report with the creation of senates. 

With the proposal to create senates, there is likely to be concern that this will create more bureaucratic levels when in fact it is efficiency and streamlining that is needed to make the NHS run more effectively for both patients and budgets. 

As senates are set to advise commissioning bodies on changes to improve the NHS, it is too soon to see how this will affect the NHS and those working within it. With over 10 years of experience working with NHS Trusts and Private Healthcare providers, MPP Locums supply quality health care and locum staff throughout the UK. 

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