Corporate report

Independent Reconfiguration Panel annual business review: 2022 to 2023

Published 12 April 2023

Applies to England

1. Foreword

I am pleased to present the annual business review of the Independent Reconfiguration Panel for 2022 to 2023.

The Health and Care Act received Royal Assent in April 2022 and introduced new legislation on reconfigurations which will give the Secretary of State for Health and Social Care new powers to call in and make decisions on proposals for NHS service change.

We have continued to work with policy officials in the Department of Health and Social Care to build on our existing good practice and help shape the development of the secondary legislation and statutory guidance required to support the new powers in the act. We look forward to the commencement of these in due course.

As an advisory public body, our core purpose remains the same: to provide independent expert advice on the safety, sustainability and accessibility of services for local populations. We stand ready through this transitional period to support health ministers with their decision making on reconfiguration proposals, as well as sharing our informal advice and support with wider health and care stakeholders.

I would like to put on record my thanks to all panel members and our secretariat who have supported an excellent learning and development programme on reconfiguration issues over the past 12 months. Through a series of local and national guest speakers and research briefings, panel members have expanded their knowledge of broader healthcare policy and strategy and its effect on NHS service design. We have covered topics including elective recovery, specialised commissioning, maternity and neonatal services, digital transformation, and the new role of integrated care systems.

Finally, I am delighted to have been reappointed by the Secretary of State for Health and Social Care to serve a further three years as chair from October 2023 and I look forward to an excellent continued working relationship with ministers, departmental officials and our wider health and care stakeholders as we work to improve NHS services in England.

Professor Sir Norman Williams
Chair of the Independent Reconfiguration Panel

2. About us

2.1 Our role and purpose

The Independent Reconfiguration Panel (IRP) is an advisory non-departmental public body established in 2003 to advise ministers on proposals for NHS service change in England that have been contested by local authorities and referred to the Secretary of State for Health and Social Care.

The Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013 require NHS organisations to consult local authorities on any proposals under consideration for substantial changes to local health services.

A local authority may refer a case to the Secretary of State for Health and Social Care if it is not satisfied that:

• consultation has been adequate in relation to content or time allowed
• the reasons given for not carrying out consultation are adequate
• the proposal would be in the interests of the health service in its area

The Secretary of State may then refer the case to the IRP to review the evidence and give advice to ministers in accordance with the IRP’s terms of reference which reflect the government’s ‘four tests’ for NHS service change which are:

• strong public and patient engagement
• consistency with current and prospective need for patient choice
• clear clinical evidence base
• support for proposals from clinical commissioners

When considering the evidence, the IRP is also mindful of a further test introduced in 2017 by NHS England which requires that for any proposal which includes plans to significantly reduce hospital bed numbers, commissioners need to provide evidence that they have met one of the following three conditions:

• demonstrate that sufficient alternative provision, such as increased GP or community services is being put in place alongside or ahead of bed closures and that the new workforce will be there to deliver it
  
  
• show that specific new treatments or therapies, such as new anti-coagulation drugs used to treat strokes, will reduce specific categories of admissions
  
  
• where a hospital has been using beds less efficiently than the national average, that it has a credible plan to improve performance without affecting patient care (for example in line with the Getting It Right First Time programme)

These five test are set out in NHS England’s guidance on planning, assuring and delivering service change for patients.

In addition to our formal advice role, the IRP also offers ongoing informal support and guidance to the NHS, local authorities and other interested parties on achieving successful service change to ensure that decisions about reconfigurations are sustainable and result in improved services for patients.

3. Our people

3.1 Chair and panel members

The IRP is led by our chair, Professor Sir Norman Williams, who is appointed by the Secretary of State for Health and Social Care and accountable to the Director General for NHS Policy and Performance Group in the Department of Health and Social Care.

The chair is supported by a panel of 15 members, including experienced clinicians, NHS managers and lay representatives, with wide ranging skills, knowledge and expertise, including an understanding of the difficult trade offs involved in complex service change and a commitment to integrity and the principles of public service.

3.2 Chair and members’ remuneration

The chair receives an annual salary of £36,780, plus travel and expenses, for a time commitment of up to two days per week, although this time may increase significantly during periods when the panel is developing casework advice to ministers.

Members are entitled to claim a fee of up to £300 per day, plus travel and expenses, for a time commitment of one to two days per month.

3.3 Chief executive and secretariat

The chair and members are supported by a chief executive who works two days a week for the IRP and a secretariat consisting of one full time civil servant employed by the Department of Health and Social Care.

3.4 Public appointments

Our chair has been reappointed by the Secretary of State for Health and Social Care for a further three years from 1 October 2023.

Members Anthony Schapira and Miles Wagstaff were reappointed for a second term of three years from 1 October 2022. The appointments of members Elaine Strachan-Hall, Tansi Harper and Graham Jagger were also extended for 12 months from 1 October 2022 to 30 September 2023.

The public appointments process was managed by the Department of Health and Social and Care in accordance with the Cabinet Office’s governance code for public appointments. The regulation of public appointments against the requirements of this code is carried out by the Commissioner for Public Appointments.

The appointments were made on merit and political activity played no part in the decision process. However, in accordance with the code, there is a requirement for appointees’ political activity (if any declared) to be made public. None of the appointees have declared any political activity.

4. Our work

4.1 Formal advice on reconfiguration proposals

The panel received no requests for formal advice from ministers in the Department of Health and Social Care in 2022 to 2023. The panel stands ready to support ministers with their decision making on reconfiguration proposals as and when required.

4.2 Informal advice and support

In addition to the panel’s formal role in advising ministers, the IRP also provides general support and advice to the NHS, local authorities and other interested parties on effective service change. The panel is mindful of the potential conflict of interest should a proposal for reconfiguration later be formally referred to the IRP, therefore the advice offered is always generic rather than specific in nature.

4.3 Policy engagement

The IRP secretariat had a number of meetings and conversations with stakeholders to discuss facilitating effective service change, revising guidance and disseminating learning and good practice throughout the year, including participation in the following working groups:

• NHS England’s co-production group for developing system wide guidance on working in partnership with people and communities
  
  
• the Department of Health and Social Care’s reconfiguration reform steering group on legislative changes to reconfiguration policy in the Health and Care Act

5. Our governance

5.1 Panel meetings

The IRP held five formal business meetings in 2022 to 2023 with minutes from each meeting published on GOV.UK.

During the year, members were kept updated on ministerial priorities and national healthcare policies to place the work of the panel in a strategic context and enhance members’ understanding of topics which may influence NHS service change in the future.

IRP business meetings held in 2022 to 2023:

• 18 May 2022, with guest speakers on NHS transformation: Sir Jim Mackey, NHS England’s National Director of Elective Recovery and Dr Vin Diwakar, NHS England’s National Medical Director for Secondary Care and Transformation, plus policy officials from the Department of Health and Social Care in attendance to update members on changes to reconfiguration legislation in the Health and Care Act 2022
  
  

• 20 July 2022, with guest speaker Professor James Palmer, NHS England’s National Medical Director for Specialised Services on changes to specialised commissioning
  
  

• 16 November 2022, with guest speaker Rob Webster, Chief Executive of the NHS West Yorkshire Integrated Care Board, on the role of integrated care systems
  
  

• 18 January 2023, with NHS England guest speakers Professor Jacqueline Dunkley-Bent, Chief Midwifery Officer, Professor Donald Peebles, National Specialty Adviser for Obstetrics, and Duncan Burton, Deputy Chief Nursing Officer, on maternity and neonatal services
  
  

• 14 March 2023, with guest speaker Dr Masood Nazir, Chief Clinical Information Officer for NHS Birmingham and Solihull Integrated Care Board on digital transformation in the NHS

5.2 Department of Health and Social Care sponsorship

The IRP is sponsored by the Department of Health and Social Care and maintains an effective working relationship with officials in accordance with the principles set out in the Cabinet Office’s guidance on partnerships with arm’s length bodies: code of good practice.

All income and expenditure relating to the IRP forms part of the department’s accounts and is managed by the sponsorship team as the budget holders.

Meetings held with the Department of Health and Social Care in 2022 to 2023:

• 11 May 2022: IRP annual review meeting with Edward Argar, Minister of State for Health
  
  
• 24 January 2023: IRP sponsorship meeting held with Tim Jones, Deputy Director of NHS Trust Policy
  
  
• 14 February 2023: IRP meeting with Jason Yiannikkou, Director of Systems, Integration and Reform

5.3 Public relations and communications

Communications and media handling support to the IRP is provided by Grayling, a public relations agency who maintain a dedicated IRP press office. The contract was awarded in July 2022 after a competitive procurement process led by the Department of Health and Social Care.

6. Our priorities for 2023 to 2024

6.1 Our advice to ministers

We stand ready to offer our expert independent advice on NHS reconfigurations to ministers in line with our terms of reference and to support the Department of Health and Social Care’s strategic aims to improve health outcomes and provide high quality and sustainable care at the right time and in the right place.

6.2 Our engagement

We will maintain effective working relationships with our stakeholders and provide the Department of Health and Social Care, the NHS, local authorities and others with informal advice as required to support the government’s wider health and care objectives, while preserving our independence and integrity.

We will work with the Department of Health and Social Care and NHS England to contribute to their strategic reforms around reconfiguration policy and support the commencement of new reconfiguration legislation in the Health and Care Act 2022.

6.3 Our membership

We will build and maintain a high performing and effective panel by promoting a culture of learning and an inclusive environment which values diversity of skills and experience from a range of different backgrounds.

6.4 Our governance

We will ensure the highest standards of good governance and financial management in compliance with the Cabinet Office’s code of conduct for board members of public bodies and HM Treasury’s guidance on managing public money.

We will be open and transparent by continuing to publish information via the IRP’s website on GOV.UK, including our advice to ministers, minutes of panel meetings, our register of interests, and information on the role of the panel and our members.

7. Annex: IRP membership as of 31 March 2023

Chair:

• Professor Sir Norman Williams

Clinical members:

• Dr Irfan Chaudry
• Dr Rajesh Khanna
• Professor Anthony Schapira
• Elaine Strachan-Hall
• Dr Miles Wagstaff

Lay members:

• Tansi Harper
• Graham Jagger
• Luke March
• Rohan Sivanandan
• Dr Suzy Walton

Managerial members:

• Professor Simon Brake
• Dr Zoe Penn
• Mark Taylor
• Nick Relph
• Michael Scott

Read more about our members’ profiles on GOV.UK