How we decide when to engage or consult

NHS organisations have a duty under Section 14Z2 of the Health and Social Care Act 2012 and the NHS Act 2006 to ‘make arrangements’ to inform, involve and consult with the public. 

To assist the CCG in deciding the most appropriate way to deliver its duty a tool has been developed to help commissioners and providers to identify whether there is a need for patient and public involvement in their activity, and if required help them plan for a level of involvement which is ‘fair and proportionate’ to the circumstances.   

The form must be completed at the start of the planning process for any activity and before operational decisions are taken which may impact on the range of services and/or the way in which they are provided.

The completed forms will be used to ensure that patients and the public are appropriately involved in the activity, and may be used as evidence in the event of a legal challenge. 

For the statutory guidance that accompanies this form for commissioners go to

The examples here indicate some circumstances where the legal duty to involve the public may apply and therefore where NHS organisations should assess this to determine the appropriate response.

As it is not possible to anticipate every such situation, the list is not exhaustive.

  • The strategic planning of services, for example, 

    • pans to reconfigure or transform services or improve health. 

    • Plans in response to the latest joint strategic needs assessment and health and wellbeing strategy.

  • Developing and considering proposals to change commissioning arrangements, for example:

    • Changes to services, new models of care, new service specifications, local improvement schemes, etc. 

    • Reconfigurations involving movement of services from one provider or location to another.

  • Procurement

    • Considering or developing proposed models, configurations or specifications for a service.

    • Commencing a procurement process. 

  • Contracts

    • Entering into a contract with a provider. 

    • Varying a contract, other than a variation required by law. 

    • Serving a notice to terminate a contract with a provider. 

    • Receiving a notice to terminate from a provider. 

  • Overview and scrutiny referral 

    • Any instance in which a referral has been made to the local overview and scrutiny committee. 

  • Equality 

    • An equality impact analysis may indicate the need for engagement, for example a lack of evidence relating to certain groups.

You can find a copy of the S14z2 form here

Last modified: 29/01/2020