The South East Clinical Senate are pleased to be able to share its latest report, ‘ Putting people at the heart of service change’, led and prepared by Helen Bell, Senate Programme Manager and Sarah Markham, Senate Patient and Public Partner.

Co-production is becoming increasingly relevant and manifest within healthcare; planning, design, implementation, review, evaluation and of course research.  It has been positioned as the gold standard for patient and public involvement; requiring equitable power-sharing in decision-making and other processes related to planning and assessing options for service change.  This report provides many valuable and informative cases of co-production in action and what has been achieved as a consequence of enabling people with lived experience to be equitable team members.  We hope it will be a valuable resource to systems undergoing service reconfiguration.

You can read the report here

The South East Clinical Senate prepared a  revised report on The Clinical Co-Dependencies of Acute Hospital Services  The first edition of this document was produced in response to a major focus on the future of acute hospitals. That focus has not diminished, and different ways of working driven by the COVID-19 pandemic have prompted a fresh look at what services we provide from acute hospitals, how we provide those services, and how they might be provided differently in the future.

It is hoped this report will add to this understanding and contribute to well-informed local debates and planning or hospital-based services.

The main report is quite lengthy, therefore a summary version is available. Should you wish to have a full copy please contact helen.bell27@nhs.net who will be happy to provide the report in full to you. 

 As a standalone report, the former teaching, training and research section has been published; Teaching, Training and Research: Workforce Considerations for Major Service Change ​​​​. This is for due attention to be focused on this important area that proves a particular challenge for systems undergoing reconfiguration.

The System Partnerships team at NHS England (NHSE) are pleased to share – Major Service Change: An Interactive Handbook - June 2023.

This toolkit provides advice, information, and support to those with responsibilities related to service change and reconfiguration. Information for each section of the service change process can be found with links to supporting resources, case studies, key documents and other materials.

Sign up here

Many of the links in this handbook lead to the "Service Change and Reconfiguration Future NHS Workspace" which is free to join and open to anyone working in NHS service change.

The handbook was reviewed and refreshed in June 2023 based on legislative and statutory duties in line with the Health and Care Act 2022. Further updates will be made as required to align with any secondary legislation or new guidance issued.

Further advice can be sought from your NHSE regional team on the potential impact of legislative change on your proposals.

Inequalities in health can drive demand for NHS services. Avoidable differences between population groups can impact the prevalence of conditions, and the ability and willingness of people to seek treatment prior to crisis. At a time of intense demand on the NHS, significant financial pressure, and critical workforce shortages, all efforts should be made to address the avoidable factors that contribute to ill health.

This briefing will support NHS finance staff to make the case for change within their organisation and local system. It not only covers the financial and economic cases for change, it also considers moral and social issues and their significance to different population groups. Throughout the briefing, relevant research is highlighted to understand the potential impact of inequality and disparities in health on the NHS. While the focus is mainly on England, the information in this document can be used more widely and is also relevant for NHS finance staff working in Scotland, Wales and Northern Ireland.

The HFMA and NHS England are working together to deliver a range of briefings and online learning modules to enable NHS finance staff to support their organisation to tackle health inequalities. This work builds on existing HFMA resources including The role of the NHS finance function in addressing health inequalities1 and a Health inequalities data sources map2.

This briefing is part of a series of publications focusing on the finance role in reducing health inequalities. Future briefings will cover the inclusion of health inequalities funding in the allocation of resources, business cases aimed at health inequalities improvement, and examples of how finance teams are supporting their organisations to address health inequalities. There will also be a series of detailed case studies providing insight into some of the challenges faced by organisations, how they overcame these challenges, and how others can learn from them.

To view the full document please click here

In September 2021, the Government published Building Back Better: Our Plan for Health and Social Care, which (among other things) is committed to a comprehensive national plan for supporting and enabling integration between health and social care, with a renewed focus on outcomes, empowering local leaders and wider system reforms.

It argues partnership working has been demonstrated and strengthened during the pandemic. Further change is required to go ‘further and faster’ with a particular focus on empowering integration at ‘place’ through the development of shared outcomes across health and social care

In this context, the Integration White Paper, Joining Up Care for People, Places and Populations, is a statement of policy intent. It was published on 9 February 2022 and is subject to a period of engagement and Government response. This briefing summarises the key proposals, next steps and consultation questions contained in the paper. You can see the Building Back Better: Our Plan for Health and Social Care here

Working in Partnership with People and Communities is a Statutory Guidance which has been developed by NHS England and a number of partners. 

Input from NHS England’s public participation networks and forums was also sourced and NHS England undertook a public consultation in May 2022.

To read the full guidance please Click Here.

The East of England Clinical Senate was approached by the Regional Virtual Ward team in June 2022 to support the work they are currently undertaking.


Dr Martin Hawkings, Head of System Improvement – Virtual Wards, East of England Clinical Quality Directorate, NHS England gave a presentation on the Virtual Ward Transformation Programme. The presentation and discussion considered:

  •  What could be the support from EoE Regional Clinical Senate?

  •  Clinical review of evidence base and opportunity to benefit from virtual wards.

The Virtual Wards Task and Finish group (a sub-group of the East of England Clinical Senate) was established to bring together opinions from clinicians and experts by experience to develop a template covering aspects of virtual ward proposals the Senate should consider when conducting a Clinical Review or potential Clinical Review. A draft paper was shared with Clinical Senates nationally with feedback incorporated into this final document.
It was agreed that a checklist will be produced for Clinical Senates to refer to as part of their independent clinical reviews. You can read the report here.

The South East Clinical Senate team, led and prepared by Rachel Bracegirdle, Senate Clinical Fellow and Clinical Dietician have produced a report on ‘Embedding healthcare sustainability in major service change.’  The aim of this report is to provide guidance to help both systems and review panels to ensure sustainability is embedded into service change proposals from the outset and to demonstrate ‘what good looks like’ for us as a Clinical Senate.  We hope this report provides a useful base to support systems to incorporate sustainability into major service change by providing key questions for systems to ask themselves when considering service reconfiguration and examples of good practice.

Click Here to view the report