Audit & Review is a short engagement assessing risks and challenges associated with the NHS service change or reconfiguration proposals following the creation of the 'call-in' powers of the Secretary of State for Health and Social Care

The new ‘call-in’ powers have made significant changes

Who can request a ‘call-in’?

Previously | Only the local Health Overview and Scrutiny Committee (Tier 1 Authorities), had the power to refer a substantial change to the Secretary of State

Updated | The new ‘call-in’ request to the Secretary of State is open to all individual(s) or organisation(s)

The link below provides the DHSC update on the changes associated with the new ‘call-in’ powers and implication for NHS bodies and local authorities.

How ‘call-in’ power have changed

Previously | NHS Commissioner determined whether a service change was ‘substantial’. This was typically undertaken in consultation with the local Health Overview and Scrutiny Committee

Updated | The previous process continues, however the Secretary of State can also determine whether a service change is ‘substantial’

What has changed within the ‘call-in’ powers

Previously | ‘Substantial’ change was broadly defined as range of services available and/or the geographical location from which services are delivered

Updated | A clearer definition (but not definite) of what is meant by ‘substantial change’:

When can ‘call-in’ powers be used ?

Previously | Referral to the Secretary of State would only be accepted once an NHS Commissioner had made a decision, and once a judicial review has been completed (if applicable)

Updated | The revised power power to allow the Secretary of State to intervene in NHS service reconfigurations at any stage

What is Audit & Review?

How it works

is a short engagement 15-25 day reviewing the service reconfiguration (or service change)

both interviews (relationship / public engagement) and documentation (key documentation such as travel analysis) from the perspective of challenge (Call-In Powers / Judicial Review)

provides two key outputs a) readiness assessment and b) action plan, which is co-designed with the leadership team

How can it be used

can be used in conjunction with proposed changes by Commissioners and Providers, as both groups can be impacted by the changes to Call-In Powers

is designed to be used at any point during the development of proposals (from initial scoping / project setup through to decision-making) and can flex accordingly

can be used in conjunction with any scale of proposal which might face a challenge, not just those which have been agreed to be a substantive change

What would Audit & Review Support?

  • Check & Challenge would provide a clearer understanding of the environment in which the proposals are to be developed within, the likely level of challenge and mitigations that would reduce the risk

  • Where reconfiguration proposals are already in development, this provides the Commissioner within a check point against which the current wider position can be understood and help inform the option development process, the draftin of the Pre-Consultation Business Case and stakeholder engagement

  • This allows the Commissioner to understand the context in which they will be making decisions, and allow further work either to inform the Decision-Making Business Case or engagement with stakeholders, which cannot be further developed once a decision has been taken

  • The revised intervention powers provide the Secretary of State with the ability to determine that a change (manner or range*) is a reconfiguration, regardless of the position of Commissioners. As a result, Commissioners might wish to utilise a Check & Challenge review to support their decision-making