Corporate report

IRP annual business review 2025 to 2026

Published 12 August 2026

Foreword

I am pleased to present the annual business review of the Independent Reconfiguration Panel (IRP) for 2025 to 2026.

It is over 2 years since the Secretary of State’s intervention powers over the reconfiguration of NHS services came into force, supported by new guidance on their use and revised guidance for health scrutiny by local authorities.

In the period for this report, there has been a steady flow of call-in requests made to ministers. In one case IRP was asked to provide advice to help ministers decide whether to exercise their intervention powers. To date no proposal for service change in the NHS has been subject to the intervention powers.

We continue to support the work of our sponsors in the Department of Health and Social Care (DHSC) and invest in our relationships with stakeholders across the system, including NHS England, clinical senates and the NHS Confederation.

We also continue providing on-demand informal advice to those working at a local level, such as NHS bodies, local authorities and the public, about any NHS reconfiguration issues they may encounter to help resolve disputes without recourse to ministers.

This is my final annual business review.

It has been a privilege to have served in this role over the years and although we have had few commissions recently, I do feel we have helped the system make sound decisions for the future of health services. I have learnt a huge amount while in the job in particular from panel members, past and present and am grateful for all their support.

I am in no doubt that to achieve the best outcomes for patients and wise use of scarce resources in a reformed and renewed NHS will require sometimes difficult and controversial changes to NHS services.

Involvement of the public, patients and clinicians in shaping these changes alongside effective leadership to deliver them are essential for progress.

I also believe that the continuing presence of IRP to provide independent expert advice provides a valuable and unique contribution.

We are greatly indebted to Fiona Gannon our Secretariat lead who stepped down earlier in the year for her superb contribution to the work of the panel during the time she was with us.

Finally, I would like to place on record our grateful thanks to Richard Jeavons who demits office after many years as Chief Executive of IRP. His huge experience and expertise in this field has been much appreciated by panel members past and present. His common sense, professionalism and sense of humour will be sorely missed.

Professor Sir Norman Williams

Chair of the Independent Reconfiguration Panel

 About us

Our role and purpose

IRP was established as an advisory non-departmental public body in 2003 as part of the government’s NHS Plan 2000. Our core function is to provide independent and impartial specialist advice to the Secretary of State for Health and Social Care about NHS reconfigurations in England.

Schedule 10A of the National Health Service Act 2006, introduced by the Health and Care Act 2022, came into force on 31 January 2024. This schedule introduced a new power for the Secretary of State to call in and make decisions on NHS reconfiguration proposals at any stage of the reconfiguration process. The Secretary of State retained IRP under the new process to support effective and timely decision making.

DHSC’s statutory guidance on Reconfiguring NHS services - ministerial intervention powers (2024) sets out that IRP may operate as follows:

• advice of the panel can be sought informally by anyone to determine if a call-in request is appropriate or to seek support to resolve issues with a proposal locally
• the panel can provide independent advice to help the Secretary of State to determine whether to use their call-in power
• in cases where Secretary of State has chosen to use their call-in power, the panel will be available to formally support the Secretary of State’s decision-making by providing impartial expert advice

DHSC’s guidance on local authority health scrutiny (2024) also sets out that where there are concerns about proposals for substantial developments or variation in health services, local authorities and the NHS commissioning body should work together to attempt to resolve these locally if at all possible. If external support is needed, informal advice is available from IRP. This includes where agreement cannot be reached on a shared definition of ‘substantial’.

Our terms of reference

Revised terms of reference for IRP were agreed by the then Minister of State for Health and Secondary Care in early 2024 to reflect the commencement of the new intervention powers, along with transitional arrangements for any outstanding cases referred to the Secretary of State by local authorities under the previous 2013 regulations.

It sets out that IRP will:

• advise ministers on the use of the call-in power under schedule 10A of the National Health Service Act 2006
• provide formal advice to ministers about called in reconfiguration proposals
• provide formal advice to ministers on proposals referred prior to 31 January 2024 under the Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny Regulations) 2013
• consider any other issues referred to IRP by ministers as appropriate

When providing advice, IRP will have regard to the duties for the Secretary of State for Health and Social Care, NHS England and integrated care boards, including but not limited to:

• the NHS Constitution
• the quality, safety and effectiveness of services
• the need to reduce health inequalities
• the integration of services with other health-related or social care services
• the extent to which NHS organisations have involved or consulted with the public and local authority health overview and scrutiny committees in the development of a reconfiguration proposal

IRP’s role is advisory and decisions on NHS reconfigurations will remain a matter for ministers. The advice offered will be independent of government and will be published for transparency.

IRP will ensure that any recommendation to ministers for use of the call-in power is separate to any future advice on the substantive issues of a reconfiguration proposal.

The government expects that, wherever possible, disagreements are resolved locally without recourse to ministers. To assist this, IRP will also offer informal advice on reconfiguration issues to NHS organisations, local authorities and other interested parties upon request.

IRP’s terms of reference are subject to review by ministers.

Our people

Our Chair, Chief Executive and members

IRP is led by our Chair, Professor Sir Norman Williams, who is appointed by the Secretary of State for Health and Social Care and accountable to the Director of Legislation in the Chief Operating Officer Group.

The Chief Executive is appointed as an office holder of DHSC for 2 days per week and is responsible for the day-to-day operations and management of IRP, including its standards of behaviour and corporate governance.

IRP consists of a panel of up to 15 members who are appointed by the Secretary of State to act in a personal capacity to provide independent specialist advice to ministers. IRP members are drawn equally from three backgrounds, clinical, managerial and lay, to ensure a diverse range of skills, knowledge and experience.

Relevant areas of their expertise include acute clinical specialties, general practice, nursing, NHS leadership, healthcare academia and representing the public and patient perspectives. A full list of our membership is available in the Annex.

Remuneration

The Chair receives an annual salary of £36,780, plus travel and expenses, for a time commitment of up to 2 days per week, although this time may increase significantly during periods when the panel is developing casework advice for ministers.

Members are entitled to claim a fee of up to £300 per day, plus travel and expenses, for an expected time commitment of 1 to 2 days per month, as and when required.

Public appointments

The Secretary of State appointed Professor Gordon Carlson CBE, Kate Denham, Dr Rob Ghosh and Christine Morgan as members of the Independent Reconfiguration Panel, for 4 years from 1 October 2025. The public appointments process was managed by DHSC in accordance with the Cabinet Office Governance Code on Public Appointments.

Our work

Independent advice for ministers

IRP was approached for advice by the Minister of State for Health on 16 May 2025 to help the Secretary of State to determine whether to exercise his discretionary power to call in a proposal for his own determination following third party requests to intervene.

The proposal was made by NHS Humber and North Yorkshire Integrated Care Board (ICB) on 10 July 2024 affecting services at Northern Lincolnshire and Goole NHS Foundation Trust.

IRP had regard to DHSC’s statutory guidance on considerations for use of the powers. NHS England was invited to submit evidence as the regulatory body for NHS integrated care boards to ensure the information about the proposal was accurate and up to date.

IRP’s written advice was submitted to the minister on 17 June 2025 and published on 13 January 2026.

As the Secretary of State is accountable to Parliament for the performance of IRP and the policy framework within which we operate, the IRP Chair is keen to work together to build a trusted and constructive relationship. IRP remains available to support the Secretary of State when local NHS proposals have been contested with them nationally to ensure the effective delivery of clinical services and improved outcomes for patients.

Informal advice and support

IRP offers informal advice on reconfiguration issues to NHS organisations, local authorities and other interested parties upon request to explain the call- in request process and help resolve local disputes without recourse to ministers where possible. This service is managed by the IRP Chief Executive and secretariat in DHSC through our central mailbox at irpinfo@dhsc.gov.uk.

Call-in requests

The IRP Chief Executive and secretariat provide informal advice to various parties about making call-in requests, the use of call-in powers and the associated statutory guidance. They also support DHSC in its consideration of call-in requests received.

NHS clinical senates

IRP has a common interest and cause with clinical senates in seeing the delivery of effective service change that brings benefits for patients. In September and November 2025, the Chief Executive of IRP met with clinical senate leaders to discuss recent developments in NHS service change policy and practice. Clinical senates are regional bodies, hosted by NHS England, that bring together a range of professionals to provide independent strategic advice to commissioners and others on how NHS services should be designed to provide the best care and outcomes for patients.

Relationship with NHS England

IRP continues to have an effective relationship with NHS England officials at a working level, with the IRP Chief Executive and secretariat meeting with NHS England’s national System Assurance and Regulation team throughout the year.

NHS England officials also supported IRP’s development programme with contributions at formal business meetings.

Our governance

Panel meetings

IRP held 4 formal business meetings in 2025 to 2026 with minutes from each IRP meeting published on GOV.UK.

During the year, members were updated on ministerial priorities and health policies to place the work of IRP in a strategic context and enhance members’ understanding of the potential drivers for future NHS service change.

In 2025 to 2026, IRP held business meetings on:

• 15 May 2025, with guest speakers Edward Jones and Skeena Williamson from the NHS Confederation who presented an update on their policy work around strategic commissioning, including a recently published report entitled ‘Pioneers of reform’
• 8 July 2025
• 11 November 2025, with guest speakers Dr Mark Hendy, Zoe Fiander and Ali Parsons from NHS England to discuss themes which may impact reconfiguration in the medium term
• 10 March 2026, with guest speakers Dr Mark Hendy, Ali Parsons and Emily Webster to discuss the NHS England service change assurance process and the contribution to it from clinical senates

Department of Health and Social Care sponsorship

IRP is sponsored by DHSC which provides its secretariat and funding. IRP does not produce its own accounts - any income or expenditure forms part of DHSC’s accounts as the sponsoring department.

In 2025 to 2026, the following meetings were held with DHSC:

• 25 June 2025: IRP annual review meeting with Karin Smyth, Minister of State for Health (Secondary Care), and the IRP Chair
• 15 May 2025, 11 November 2025 and 11 March 2026: the Director of Legislation in the Chief Operating Officer group (also IRP senior sponsor for DHSC) attended IRP’s business meeting to update members on departmental policy priorities
• 8 July 2025 and 1 October 2025: IRP Senior Sponsor meetings held with the IRP Chair and Chief Executive

Public relations and media handling

Public relations and media handling support to IRP has been provided by Grayling Communications Ltd, a public relations agency, who maintain a dedicated IRP press office. This contract ended in July 2025 and was replaced by support from DHSC.

Our priorities for 2026 to 2027

Our independent advice for ministers

We will:

• continue to offer our impartial expert advice on NHS reconfigurations to support the Secretary of State to determine whether to use the call-in power for contested NHS reconfiguration proposals, as well as give advice and gather representations from the parties for any proposals that have been called in for the Secretary of State’s own determination
• be available to act as a sounding board for ministers to draw on our expertise for the policy development of NHS reforms where appropriate, including where new technology, the shift of services from hospital to the community and the development of a neighbourhood health service requires or is enabled by service change
• This will support the Secretary of State to fulfil their legal duties in Schedule 10A of the NHS Act 2006 for intervention powers over the reconfiguration of NHS services and support the government’s Health Mission to build a health service fit for the future

Our stakeholder engagement

We will:

• be available to provide informal advice on NHS reconfiguration issues to NHS bodies, local authorities and the wider public upon request to help resolve any disputes at a local level without recourse to ministers to support devolved decision making by NHS integrated care boards where possible
• engage with stakeholders across the health and care system for their insights to inform development of our advice and identify potential challenges and opportunities around NHS reconfiguration planning, assurance and delivery

Our membership

We will:

• build and maintain a high-performing and effective panel with an inclusive and diverse culture which values different perspectives and backgrounds and upholds the values of the Seven Principles of Public Life
• work with ministers and DHSC on succession planning and individual public appointments campaigns to support the Secretary of State to make timely, well-informed decisions about the appointment of new members

Annex: IRP membership at 31 March 2026

Chair: Professor Sir Norman Williams

Clinicians:

• Professor Gordon Carlson CBE
• Mr Mark Cheetham
• Dr Rob Ghosh
• Dr Rajesh Khanna
• Dr Elaine Strachan-Hall

Lay members:

• Kate Denham
• Tansi Harper
• Graham Jagger
• Christine Morgan
• Dr Suzy Walton

NHS leadership and management:

• Professor Simon Brake
• Ann Lloyd CBE
• Angela McNab
• David Stout
• Andrea Young

Read more about our members in their biographies on GOV.UK