The London Clinical Senate is hosted by NHS England (London region) but operates independently. It has no executive authority or legal obligations.

The Senate makes recommendations for consideration and implementation as determined by statutory organisations. Commissioners – including Clinical Commissioning Groups (CCGs) and NHS England – remain accountable for the commissioning of services, and providers remain accountable for the quality of service delivery. The Clinical Senate, however, serves as an important enabler of change through the clinical leadership and engagement that it provides.

London Clinical Senate Guiding Principles

As part of the London Clinical Senate’s development event in January 2014, the Senate Council and Patient & Public Voice (PPV) group identified a set of principles that provide a framework for the work of the Senate.

The framework is applied when formulating advice by considering how the issue(s) in question addresses each of the principles and then making recommendations to increase the focus on any principles where indicated. Another way to apply the framework could involve the Clinical Senate proactively leading work in related areas e.g. self-care and ensuring the other principles are considered as part of the approach.

The principles are:

  • Enables a seamless patient journey
  • Is patient-centred
  • Supports self-care
  • Improves standards (including the use of evidence and research, and the application of best practice and innovation)
  • Improves outcomes (including the use of evidence and research, and the application of best practice and innovation)
  • Ensures value (this includes issues such as sustainability, implications for the clinical workforce, consideration of unintended consequences)

This approach will be reviewed by the Senate during 2015/16.


Terms of reference

The Clinical Senate terms of reference sets out the role, responsibilities, scope and membership of the Senate and Forum, as well as their decision making process and guiding principles.

London Clinical Senate – Terms of Reference

Conflict of interest

The Standards of Business Policy sets out how members of the Clinical Senate must conduct themselves within the role as well as how (potential) conflicts of interest are handled.

London Clinical Senate – Conflict of Interest and Standards of Business Policy

Process for requesting advice

The advice process policy outlines that which the Clinical Senate will consider (or not) and the process by which statutory bodies can request that advice.

Process for requesting the London Clinical Senate’s advice

Template for requesting advice from the London Clinical Senate


These documents provide the background to the creation of the Clinical Senates across the NHS in England.

Developing Clinical Senates – The Way Forward
The NHS belongs to the people – a call to action
Single Operating Framework
Clinical Senate Review Process – Guidance Notes