London has some of the best health and care services in the world but they don’t always meet the needs and expectations of Londoners. Successful efforts to transform stroke care demonstrate the ability of London’s health and care system to collaborate and commit to improved health outcomes.
But we also know that sometimes health and care services fall short of what patients expect and deserve.
We aim to work towards having the lowest death rates for the top three killers, and to close the gap in care between those admitted to hospital on weekdays and at weekends.
Providing high quality and consistent urgent and emergency services in London
To further strengthen the 111 service, London is piloting a digital solution that enables NHS 111 services to retrieve patient crisis or care plans during clinical decision-making. This will ensure that patient care needs and wishes are followed, 111 callers do not have to repeat information from previous calls and, if ambulance crews are required, view crisis information from 111 enroute or at the scene. Londoners now have access to a range of specialists by calling 111.
London 111 pharmacy services have expanded this year. A survey of London 111 callers demonstrated that without 111 pharmacy services, 41 per cent would have gone to A&E and 19 per cent would have not taken their medication.
Five U&EC networks are being developed in London. Each brings together diverse stakeholders to address the challenges in their geographical area and transform local services. HLP has worked with clinical leaders, patients and commissioners to develop a systems and facilities specification that reduces confusion and meets Londoners’ expectations. This aims to deliver consistent U&EC services seven days a week across the capital. Networks are now beginning to design their U&EC services, including the designation of services to improve the quality, access and outcomes of care. Barking & Dagenham, Havering and Redbridge will go faster in developing an U&EC network, as a vanguard site. Monitor has agreed to support two further London pilots of new payment models for U&EC to support the delivery of high value care.
Improving cancer care
Three ‘Be Clear on Cancer’ campaigns were delivered this year to improve awareness of the signs and symptoms of cancer in London. HLP has supported CCGs and providers to:
Improve waiting times, learning from organisations who have achieved sustained improvements.
Support patient choice of care services.
Produce standards for managing cancer as a long term condition in primary care
Develop new commissioning guidance to ensure appropriate and adequate access to psychological support during and after active cancer treatment.
Delivering care in centres of excellence
North central and north east London are reconfiguring cancer and cardiac services to create centres of excellence. NHS England and CCGs are considering how the lessons can be best applied to other parts of London.
Delivering holistic and integrated services for population groups with similar needs
Many SPGs, CCGs, local providers and health and wellbeing boards are tailoring services for specific population segments. This approach is used for adults in north west London and for children and young people in south east London. Some CCGs have begun to trial capitated budgets for specific groups of the population, such as the frail elderly, based on outcomes that matter to these populations.
Lambeth and central London CCGs have been appointed as lead commissioners for a collaborative pan-London, multiagency model of healthcare for homeless people. Through integrated working that is more responsive to the complex needs of this vulnerable population, the new model will support early intervention and improve care pathways. CCGs will commission services based on health outcomes for this population group.