On 21 June 2010, the Secretary of State published the revised Operating Framework for 2010/2011 which sets out four tests against which reconfiguration processes need to be assessed. The Framework requires existing and future reconfiguration proposals to demonstrate:

  • support from GP commissioners;  
  • strengthened public and patient engagement;
  • clarity on the clinical evidence base; and  
  • consistency with current and prospective patient choice.

On 29 July 2010, the Department of Health (DH) released guidance on the application of these four tests. The guidance asks local GP commissioners, supported by PCTs, to lead reconfiguration processes locally and to assure themselves, and their SHAs, that any proposals pass the four tests. The guidance grants flexibility on how to gather the evidence of support. The DH argues that the process needs to be locally-led and designed and so does not define specific thresholds for any of the tests.