Consultation for service change

During service change and reconfiguration planning, engagement activities must develop on-going dialogue with patients, public and local stakeholders. From initial proposal through to implementation, it forms a vital part of the process and must offer patients, public and staff the opportunity to shape and contribute to the future of services.

offers advice and guidance on how to engage throughout service change, meeting your moral and legal responsibilities.


The Health and Social Care Act 2012 dictates the NHS has a duty to involve people in decisions about their health care and to consult and involve people when planning or changing commissioned health services.

Good engagement is an important principle in service change – it will help develop strong evidence base, meaning you are able to meet your legal duties.


There are a variety of ways to engage with patients, public and local stakeholders during times of service change. Many of them are activities highlighted elsewhere on this website:

  • Identifying stakeholders – define those groups you should target your engagement with
  • Events – large or small-scale, events can be a practical, proportionate way to reach large or more specific groups of people at one occasion
  • Social media – decide what platforms are best to help you engage your target audiences through
  • Communications – use channels open to you in your place of work and across other organisations
  • Patient groups – working with these groups may help you gather a consensus from a particular group or community
  • Patient experience – using a variety of innovative and tried-and-tested techniques can help you understand how your population feels about a particular area of service change


Patients and public across affected communities, as well as other stakeholders, should be engaged with at all stages of the process – not just during times of formal consultation. These are the stages of service change during which to engage:

  • Proposal – when setting out the range of service changes that could improve outcomes within available resources, commissioners have a duty to engage service users, including patients, public and other stakeholders
  • Discussion – defined as the ‘pre-consultation’ stage, at this point, commissioners should discuss the proposal with local stakeholders prior to any wider public consultation
  • Consultation – commissioners may undertake a formal consultation to gather views and feedback on specific service configuration options open to them. Engagement should be targeted, tailored and proportionate
  • Decision – commissioners should keep stakeholders informed of any decision they make to proceed with a configuration option
  • Implementation – dialogue with patents and public is important when new services open, but organisations must also seek and act on feedback as people experience those services


Good service change planning will involve developing a full stakeholder list and map. Engagement activities should take into account all of those groups defined in this work. Visit Identifying Stakeholders to find out more.



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