Changes to NHS England’s Clinical Reference Groups

NHS England has been consulting on proposed changes to Clinical Reference Groups (CRGs). CRGs are groups of clinicians, commissioners, public health experts, patients and carers who provide advice to NHS England based on their specific knowledge and expertise. CRGs provide advice on various areas such as service specification development, commissioning policies, innovation and quality of services.

Each CRG has had, up until now, two patient and public voice (PPV) members. We feel that the recruitment of these members is an integral part of getting CRGs to work for patients. Recruitment of PPV members needs to be focused on finding people who have the skills to effectively represent the communities for which the CRG is salient. They need to be able to represent the wider community, not one small group, being capable of bringing consensus, gathering the opinions of a range of stakeholders where appropriate and be well placed to disseminate news and opportunities to the community.

In light of the changes being proposed to CRGs, specifically in terms of merging some of the current groups, there will be many fewer PPV members. This makes the effective recruitment of the right people even more important. We need a clear and proportionate recruitment process, with a programme if work and terms of reference which are published.

Whilst NHS England consults on the substantial changes to CRGs, we have been surprised to note that the implementation appears to have begun already. In the past few weeks it has become apparent that NHS England’s intention is to close the existing CRGs before the end of March 2016, and before recruitment for the replacement begins. The fact that at least one CRG (Metabolic Disease CRG) has been closed before the end of the consultation raises serious questions as to how seriously NHS England will be taking the results of this consultation. The premature dissolution of CRGs will leave a wholly avoidable gap in expertise. We do understand, however, that there will be further opportunities for patient involvement as part of working groups.

In our response to the consultation we have outlined some key proposals that we believe should be implemented at this stage:

• Best practice guidelines should be developed for Clinical Reference Groups in consultation with members and stakeholders
• A technical review of the current Clinical Reference Group structure should be carried out to ensure coverage, capacity and expertise is appropriate across portfolios
• A detailed strategy for recruitment to clinical reference groups needs to be published
• Clear terms of reference for clinical reference groups and their affiliated groups needs to be published
• A more thorough review of the coverage of all clinical reference groups’ remit, with steps taken to ensure all disease areas are effectively covered.