The South West Clinical Senate provides commissioners of health and care services with a source of independent clinical advice to help them to make the best possible decisions about health and care provision in the South West. From September 2014, the 12 Clinical Senates across England took on the role delivered by the National Clinical Assurance Team (NCAT) until April 2014, to review major service change proposals against the clinical evidence base for them.
As a significant service change proposal is developed and refined commissioners should ensure it undergoes a rigorous self-assessment to comply with the Department of Health’s four tests for service change against the four tests. The four tests are:
- Strong public and patient engagement.
- Consistency with current and prospective need for patient choice.
- A clear clinical evidence base.
- Support for proposals from clinical commissioners.
From 1st April 2017, NHS England assurance teams also need to see that significant hospital bed closures can meet one of three new conditions.
The Clinical Senate is set up to provide independent clinical review and assurance against test 3 (a clear clinical evidence base) and test 5 (the case for changes to bed numbers).
It offers two types of review:
Early Advice – ‘read and review’ to provide a strategic sense check prior to options being developed for a service change. This might involve a working group from the senate council looking at the clinical case for change online and feeding back comments or meeting as a panel to discuss. The topic could go to the council meeting for advice.
Clinical Review – this would bring together a panel of clinicians relevant to the topic area who might conduct site visits, review service change documentation and pre-reading and meet with service providers as a panel to advise whether the clinical evidence base for the options laid out is robust. This would happen after commissioners have developed options and before they go to public consultation. This is a recommended part of the NHSE stage 2 assurance check point that gives the go ahead for service change proceeding to public consultation.