INDEPENDENT RECONFIGURATION PANEL

HOW WE ADVISE THE SECRETARY OF STATE FOR HEALTH

1Who refers proposals to the Secretary of State and why?

1.1The Local Authority (Public Health, Health and Wellbeing Boards and health Scrutiny) Regulations 2013 require NHS organisationsto consultlocal authoritieson any proposals under consideration for substantial changes to local health services. If theauthority is not satisfied that:

  • consultation has been adequate in relation tocontent or time allowed
  • the reasons given for not carrying out consultation are adequate
  • the proposalwould bein the interests of the health service in its area

it mayrefer thematter to the Secretary of State for Health. The Secretary of State may seek advice from the IRP before deciding on the matter.

2What is the IRP’s role?

2.1The IRP is the independent expert on NHS service change. We offer advice to the Secretary of State on proposals for health service change in England that are being contested.The Panel’s terms of reference can be found in the accompanying document IRP: general terms of reference.

2.2The IRP is made up of clinical, managerial and lay members offering wide-ranging experience in clinical healthcare, NHS management and public and patient involvement. Biographies of the chairman and members can be found in the accompanying document IRP: membership. The focus of our work is the patient and quality of care within the context of safe, sustainable and accessible services for local people. Depending on the nature of the proposals we are asked to review, these three aspects may incorporate issues such as workforce, estate, use of technology or finance.

3What powers does the IRP have?

3.1We offer advice only. The Secretary of State makes the final decision on anycontested proposals.

4Do all referrals to the Secretary of State come to theIRP?

4.1Wherever possible, decisions about how the NHS is run should be made locally by those directly involved. Before acontested proposal isreferred to the Secretary of State, the organisations involved should satisfy themselves that all other options for local resolutionhave been fully explored.

4.2The IRPand the Department of Healthhaveagreeda protocol for handling the referral ofcontested proposals, attached at Annex A. The IRP will undertake an initial assessment of any referral to the Secretary of State for Health where our advice is requested.However, this does not mean that all referrals to the Secretary of State for Health will automatically be reviewedin full by the IRP.

4.3On receipt of the appropriate documentation, theIRPwill carry out an initial assessment of the referral and assess its suitability for fullIRP consideration. This usually takes 20 working days. The initial assessment process islargely based on documentary evidenceand the IRP does not usually, at this stage, seek information from other interested parties or arrange to take oral evidence from the parties involved. The information required for the IRP to carry out an initial assessment is:

  • the referral letter and supporting documentationfrom the referring body
  • an IRP initial assessment templateproviding relevant background information completed byNHS England

4.4Where a referral isnot suitable for fullIRPreview,we willexplain whyand, where possible,provide advice to the Secretary of State onfurther action to be taken locally. The Secretary of State will make the final decision about what happens next.This usually takes around one month.

4.5Where a referral issuitable for fullIRP review,the Secretary of State will then decide whether to commission a full review. Once a full review has been requested,specific terms of reference and a timetable for reporting will be agreed.Again, this may take around one month. The timescale for the review itself will depend on the scale and complexity of the proposals under consideration but a “typical” review may take around three months.

5How does the IRP review formal referrals?

5.1As many members as possible will take part in visits, meetings and interviews. Where appropriate, a sub-group ofmembers may be formed tolead ona review. Different members may be involved on different days but all information is shared and the Panel as a whole will discuss evidence and exchange views in coming to a consensus on our recommendations.

5.2The process begins with a mobilisation phase in which the Panel secretariat contacts the referring body and relevant NHS organisations to establish lines of communication and arrangemeetings to explain responsibilities and requirements for the review. This includes gathering information about the interested parties that may wish to contribute and also the locations that the Panelshould visit. Additionally, the Panel chairman writes to editors of local newspapers and other local media to advise them of the IRP's involvement. The aim is to ensure that anyone with an interest is aware of our review and of the opportunity to offer evidence.

5.3The next phase involves familiarisation in which Panel members visitthe locality and sites affected by the proposals. This ensures that members have a good mental picture of sites, the locations in which they are set and the journeys involved when they consider oral and written evidence.

5.4Evidence-taking is undertaken in a variety of ways. We consider all forms of relevant information and will consult withpeople from all sides of the debate.People can present their views and evidence to us by email, letter, by leaving a voice message or in an interview or meeting.Comments, photographs, copies of relevant documents or press cuttings are all accepted. You can contact us at any stage in the review process though we do ask that you observe the review timescale and avoid submitting large items of evidence in the final few days.

5.5The Panel is interested in all views and evidence so that we can reach a balanced and informed conclusion about the proposals.We encourage any person or organisation that feels they have new information or believes that their voice has not previously been fully heard to contact us. This includes members of the public, patients, NHS managers, clinical and non-clinical staff, local authorities, overview and scrutiny committees, voluntary organisations, media representatives and any other interested parties.

5.6We try to listen to as many stakeholders as possible during site visits, meetings and interviews, although unfortunately we cannot meet everyone. Prior experience or involvement in a review process is not necessary. Helpful hints for people wishing to present evidence to the Panel are provided in the accompanying document IRP: advice on presenting evidence to the IRP.

5.7Please note that we are unable to respond to individual submissions but everyone who offers views or evidence to the IRP during a review,including those attending formal meetingsand interviews,will be acknowledged in the appendices to our report - unless you request otherwise.Please let us know if you would like the views or evidence you offer to be treated as confidential.

5.8Please note: unless you tell us otherwise, or unless the content is clearly confidential, we will assume that all documentary evidence submitted to us is in the public domain.Anyone submitting written evidence should be aware of their responsibilities under the Data Protection Act and all aspects of patient confidentiality.

5.9TheIRP usually aims to submit its advice in 60 working days (though more time may be required for particularly large or complex reviews). The full Panel will agree the recommendations to be submitted to the Secretary of Statewho may choose to accept all, some or none of our findings.The IRP is independent. We conduct each review without any preconceived ideas and we aim to be as inclusive as possible. Throughout our consideration, our focus is on the needs of patients and the highest possible quality of care within the context of safe, sustainable and accessible services for local people.

6What happens after a review?

6.1We publish our report on the IRP website so that the public can see who we have spoken to, the information we have taken into account, our conclusions and how we reached them.

6.2We aim to co-ordinate publication of our report with the announcement of the Secretary of State's decision on the matter. This is usually (though not definitively) arounda month after submission.

6.3Once our report has been published, our role is complete.The IRP has no responsibility for the implementation or monitoring of the implementation of the Secretary of State's decision.

7How to contact the IRP

7.1You can get in touch with us by:

  • email:
  • voice message: 020-7389-8046
  • write to: IRP, 6th floor, 157-197 Buckingham Palace Road, London, SW1W 9SP

7.2You can view our website at:

ANNEX A

PROTOCOL FOR HANDLING REFERRALS OF CONTESTED RECONFIGURATION PROPOSALS TO THE IRP

1The Department of Health (DH) will keep the Independent Reconfiguration Panel (IRP) informed of actual or potential referrals, and advise the Panel when a contested proposal has been referred to the Secretary of State for Health (SofS).

2On receipt of a referral from a local authority to SofS, DH will contact NHS England and request additional information to enable the IRP to carry out an initial assessment of the referral. This information should be provided by NHS England within two weeks of request. NHS England may seek the assistance of the relevant NHS decision-making body/ies where appropriate.

3The minimum information required for the IRP to carry out an initial assessment is:

  • information requested in the IRP initial assessment template comprising:
  • names and addresses or relevant organisations
  • a map in electronic format of the relevant area
  • a description of the proposals with a chronology of events and NHS England view
  • basic background information as outlined in the template
  • supporting documentation including the consultation document, papers for the NHS body decision-making meeting, and a record of that meeting
  • lead contacts at NHS England, NHS decision-making body/ies, contesting body/ies
  • the referral letter and supporting documentation

4Once the above information has been received, DH will write to IRP requesting an initial assessment of the contested proposal and enclosing the supporting information.

5The IRP will provide an initial assessment in 20 working days of receiving the DH request and supporting information. IRP members will consider whether or not the referral issuitable for full IRP review.

6Decision that referral is not suitable for full IRP review:

  • the Panel sets out its reasons and, where possible, makes recommendations on further action to be taken
  • SofS replies to local authority, copied to NHS England, advising of decision and future action –IRP advice is published on website (usually around one month after submission)

7Decision that referral is suitable for full IRP review:

  • IRP and DH agree specific terms of referral based on IRP general terms of reference and appropriate timetable (usually 60 working days though a longer timescale may be required depending on the circumstances)
  • SofS writes to IRP confirming terms of reference
  • Panel consideration of the case including written evidence, site visits, interviews with key stakeholders, determination of advice and writing of Panel’s final report (usually 60 working days)
  • IRP submits its report to SofS
  • SofS replies to local authority, copied to NHS England, advising of decision and future action – IRP advice is published on website (usually around one month after submission)

DH/IRP PROTOCOL FOR HANDLING REFERRALS TO THE IRP
INDEPENDENT RECONFIGURATION PANEL / DEPARTMENT OF HEALTH
DH monitors potential referrals, advises IRP when a proposal has been referred to SofS by a local authority
Upon receipt of a referral, DH contacts NHS England to request additional information required - to be provided within two weeks of request
DH writes to IRP requesting initial assessment of the referral enclosing supporting information
IRP Panel Members carry out initial assessment and consider suitability for full IRP review - response in 20 working days of request
Where IRP advises that a case is not suitable for full IRP review, it sets out its reasons and, where possible, makes recommendations on further action to be taken / SofS replies to local authority, copied to NHS England, advising of decision and further action
Where IRP advises that the case is suitable for full IRP review:
IRP and DH discuss and agree specific terms of reference and timetable for IRP providing advice to the Secretary of State
SofS writes to IRP referring case for full Panel consideration
Panel consideration (usually 60 working days):
  • Written evidence
  • Site visits
  • Evidence-taking from key stakeholders and interested parties
  • Determine advice
  • Report writing

IRP submits final report to SofS
Report published on IRP website(usually around one month after submission) / SofS replies to local authority and ministerial decision announced

31.07.17