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<p>The reconfiguration of local health services is a matter for the local National
Health Service. All service changes should be led by clinicians and be in the best
interests of patients, not driven from the top down.</p><p> </p><p> </p><p> </p><p>It
is for NHS commissioners and providers to work together, with local authorities, patients
and the public, in bringing forward proposals that will improve the quality, safety
and sustainability of healthcare services.</p><p> </p><p> </p><p> </p><p>Any changes
must be supported by the Government’s four tests for service change, namely:</p><p>
</p><p> </p><p> </p><p>- support from general practitioner commissioners;</p><p> </p><p>-
clarity on the clinical evidence base;</p><p> </p><p>- robust patient and public engagement;
and</p><p> </p><p>- support for patient choice.</p><p> </p><p> </p><p> </p><p>Once
a decision on a local case for change has been made, it is up to the NHS to ensure
its local services meet the needs of its population.</p><p> </p><p> </p><p> </p><p>More
generally, we would expect any local plans for changes to acute services to take full
account of the impact on neighbouring hospitals.</p><p> </p>
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