The NHS Confederation supports the need for reconfiguration across the NHS to deliver safe and modern healthcare and to move more patient care out of hospitals and into the community.

We are keen to stress reconfiguration is needed to improve health outcomes rather than for financial reasons. There has been much recent public and media debate about implications such as hospital closures and yet most decisions about shifting services have been under discussion for some time. What has brought these decisions to the fore is the introduction of the Payment by Results regime, choice and contestability, and the greater integration of services to improve health outcomes. The white paper Our health, our care, our say has also set clear goals for the transfer of services to community settings.

Better outcomes for patients will mean it will not be possible for every hospital to provide every service, and patients may need to travel further for complex or specialist cases. This may be a particular issue in the areas of emergency surgery, obstetrics and paediatrics.

However, it is important to stress these changes are required whether or not there are NHS deficits - indeed, some trust deficits may have arisen because service configuration was not made earlier.

During 2007, we shall be running several workshops and briefings on the assumptions driving reconfiguration, strategic planning tools and processes, and examples of innovative models of care and service configuration.

We are particularly keen to make the clinical case for change by working with the Joint Consultants Committee and the Royal Colleges, and by building on the reports from the national czars on 'Emergency access' and 'Mending hearts and brains". We shall be publishing 'Frequently Asked Questions' for the public and politicians in the summer.

How we involve members

We hold specific seminars and meetings to inform our policy positions - invitations either appear in our email bulletin Interchange Alert or are sent out individually. We have regular meetings bringing together key stakeholders with NHS Confederation members.

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