Alex Hern details the concerning information to be found in NHS London’s assessment of the risk imposed by the government’s top-down reorganisation of the NHS.

NHS London has released its assessment (pdf) of the risks associated with the government’s top-down reorganisation of the NHS, and it is not optimistic about the effect it will have on health in the capital.

With regards to the overall introduciton of the major service changes, the document warns:

There is a risk that, during the transition to a new end-state for decision-making processes and accountability, there may be insufficient focus to deliver the necessary transformation at pace.

This applies both to existing changes that are agreed but not yet fully implemented and to proposed changes that will emerge over the remainder of 2011.

The consequence of this risk could be that the transformational changes in health services envisaged in London’s QIPP plans in response to the clear clinical case for change, may not be realised in full or are delayed, thereby undermining significant improvements in the health of Londoners.

Talking about “planning for and implementing the Government’s White Paper reforms”, it euphemistically concludes that:

The consequences of this risk could be patients receiving sub-optimal care.

The consequences of abolishing primary care trusts:

…could be that the quality of the commissioning of health care may be poor, both in securing the best health outcomes for London’s population and in maximising value for money.

Finally, and most shockingly, the document covers the risk to children that loss of expertise could lead to, and concludes:

The consequences of this may be preventable harm to children,  damage to the reputation and loss of public confidence in NHS London and the NHS in London.

This risk assessment is the local version of the national document that the government have been fighting the information commissioner over.

As Baroness Thornton said in the Lords, regarding the attempt to secure a release of the NHS risk register:

“In 2008, Justine Greening MP used an appeal to the Information Commissioner to get the release of risk documentation relating to the Heathrow third runway. My own government did not cover itself in glory in this matter, refusing to part with the information for more than a year.

“But the key difference with runway three and now is that, of course, the third runway was not the subject of a very large piece of primary legislation that aimed to bring radical change to our NHS. The information we are being denied could be very relevant to our current deliberations.”

If the document they’ve released is this bad, how bad is the one they’re hiding?

See also:

• Sign my petition to drop Lansley’s monster – Dr Kailash Chand OBE, November 24th 2011

• How Tories wrecked the NHS (but learnt to love targets (too late)) – Alex Hern, November 17th 2011

• Like arthritis, Lansley’s NHS bill is attacking the very thing it should protect – Jos Bell, October 21st 2011

• UK Uncut: Stop the traffic to stop the NHS being run over – Tim Holmes, October 7th 2011

• Second reading of NHS bill offers a second chance to kill it – Alex Hern, October 6th 2011