The Government are clear that any changes to local health services should be locally-led, improve quality and with decisions made in the best interest of patients. Under section 242 of the National Health Service (NHS) Act 2006, NHS organisations must make arrangements that secure the involvement of people who use services in the development and consideration of proposals for changes in the way those services are provided. This was strengthened further in 2010 by the Secretary of State's four reconfiguration tests, which require NHS organisations to demonstrate evidence of: robust public and patient engagement; support from local clinical commissioners; support for patient choice; and clarity on the clinical evidence base. Where local communities have concerns over proposals, we would expect the NHS to listen and respond to these concerns as part of any engagement activity.
The outcome of a service reconfiguration consultation is also subject to scrutiny by local authority scrutiny committees. Where a committee is not satisfied with the content of the consultation, or that the proposal is in the interests of the health service in its area, it has powers to refer these issues to the Secretary of State. In addition, the Government propose in the Health and Social Care Bill to extend the powers of local authorities to enable effective scrutiny of any provider of any NHS-funded services.