Press release -

Department of Health: No more top-down reconfigurations in the NHS

Health Secretary outlines vision for locally led NHS service changes

The NHS must make sure that patient outcomes and clinical evidence are at the heart of any changes to health services, Health Secretary Andrew Lansley said today.

In future, all service changes must be led by clinicians and patients, not be driven from the top down.

Health Secretary Andrew Lansley said:

"Today I am fulfilling the pledge I made before the election to put an end to the imposition of top-down reconfigurations in the NHS.

"We are committed to devolving power to local communities – to the people, patients, GPs and councils who are best placed to determine the nature of their local NHS services.

"Local decision-making is essential to improve outcomes for patients and drive up quality.”

Mr Lansley outlined new, strengthened criteria that he expects decisions on NHS service changes to meet.  They must:

  • focus on improving patient outcomes;
  • consider patient choice;
  • have support from GP commissioners; and
  • be based on sound clinical evidence.

Local NHS organisations, which have already started to look at changing services, will need to make sure that that their plans meet these criteria before continuing.

This change will provide an opportunity for GPs to work with community leaders and their local authorities to take the reins and steer their local services to improve quality standards and outcomes.

Mr Lansley added:

“As part of this, I want NHS London to lead the way in working with GP commissioners in their reconfiguration of NHS services.

“A top-down, one-size fits all approach will be replaced with the devolution of responsibility to clinicians and the public, with an improved focus on quality.

“It will be centred on a sound evidence base, support from GP commissioners and strengthened arrangements for public and patient engagement, including local authorities.”

Notes to editors

1.      The Secretary of State has previously made a number of commitments relating to local service reconfigurations. In light of the principles being outlined by the Secretary of State today these commitments still stand.

2.      Chief Executive of the NHS, Sir David Nicholson, will be writing to all NHS organisations setting out the need for service reconfiguration plans to meet these criteria.

3.      This applies to all future reconfigurations and those that are ongoing.  More detailed guidance will be issued in the summer.

4.      For media enquiries only, contact the Department of Health Newsdesk on 020 7210 5221.


NDS Enquiries
Phone: For enquiries please contact the above department


  • Government


  • health services
  • health secretary