London Health and Care
The information below has been largely re-produced from
London Health and Care Devolution team from their first
Additional content includes links to additional
information; LVSC's intentions and further links to useful
resources for the voluntary & community sector.
From the London Health and Care Devolution team, the information
includes the latest news and updates from the devolution pilots on
prevention, integration and health and care estates. Please forward
it on to colleagues who are might be interested in health
devolution in London.
The Kings Fund produced a
briefing describing the origins of the devolution agenda should
want to find out more.
Since early 2014, London's 32 Clinical Commissioning Groups, NHS
England, London Councils, the Greater London Authority and Public
Health England have been working together to improve the health and
care for Londoners.
A number of reports and plans formed the foundations for
continued partnership working;
Better Health for London set the vision,
Better Health for London: next steps outlined how to get there
Better Health for London: one year on reassured London partners
that they are making real progress but we have a lot more to do and
could make more of opportunities to go further and faster.
In December 2015, London partners signed the
London Health and Care collaboration agreement to deliver a
unified solution for London. In support of this, central government
London Health Devolution agreement inviting the health and care
system to explore if devolution - the transfer of powers,
decision-making and resources closer to local populations - could
accelerate transformation plans.
Will Tuckley, Chief Executive London Borough Tower Hamlets, CELC
Health Lead and Chair of the London Health and Care Devolution
Board (see below) says health devolution "presents a major
opportunity for health and care in London. If we can minimise
bureaucracy by making decisions locally, we believe we can go
further and faster in delivering our plans for a more tailored,
responsive and sustainable health and care system."
Will Tuckley recognises the health and care system in London is
large and complex - for that reason, the Board will be
"testing how devolution could work in practice through five
pilots across London. The pilots are focusing on three themes -
prevention, health and care integration and making best use of
health and care buildings and land. These pilots will test
decision-making at local and multi-borough and London
The Board team will support pilots to secure devolved powers this
year with shadow operation by next year. Most importantly, they
want to share learning from the pilots as quickly as possible, so
that other parts of London - and the wider country - can benefit
from these experiences.
The programme board
Devolution Programme Board is providing operational oversight
of the devolution programme and provides an opportunity for London
partners and national bodies, including central government
departments, NHS England and NHS Improvement, to work through
London's health and care challenges and co-develop devolution
proposals. The Programme Board first met in March 2016 and to date
has undertaken 'deep-dives' on each theme to review the potential
opportunities emerging from pilots.
London Health Board, chaired by the Mayor of London is
providing political oversight to the Devolution Programme.
What has happened to date?
London's new Mayor to champion health, Sadiq Khan has been in
office as Mayor of London since May 2016 and has made a number of
pledges to improve the health of London. Many of the themes being
explored through devolution were highlighted in his
manifesto. He has pledged to be a champion for London's NHS and
to work with the health service and partners to improve the
integration of services. He has committed to campaigning for
extra powers to improve the coordination of health services around
the needs of Londoners and to support local boroughs to take the
lead on prevention and to design services around local
communities. The housing challenge is
also one of his priorities for London and he has committed
to working with the NHS to look at repurposing land and estate for
public sector workers.
Piloting devolution in London
Haringey is exploring the licensing and planning powers
needed to shape healthy environments; and support for people with
mental health conditions who are on sickness absence but not yet
Three of London's five devolution pilots are focused on
health and care integration:
Barking & Dagenham, Havering and Redbridge is
delivering a personalised health and care service focusing on
self-care, prevention and local services that enable the
sustainability of the health and care system. Emerging devolution
opportunities involve the need to engage effectively with national
partners regarding regulation, workforce and training and the need
to increase the pace on estates work as a key enabler of
Hackney is bringing together health and social
care to fully integrate both budgets and jointly provided services,
with a particular emphasis on prevention. Devolution opportunities
relate to regulation, finance and capitated budgets, commissioning
powers and estates.
Lewisham is creating "One Lewisham Health and
Social Care system" by combining mental and physical health
services and social care. To support this work, Lewisham has
identified estates as a key enabler.
Three key enablers have been identified to support health and care
integration: regulation; funding; and workforce. Pilots are working
together to identify opportunities within the existing system and
through devolution in each of these areas.
North Central London is exploring how to make better use
of health and care buildings and land, increasing value from unused
and underutilised estate in order to release land for other health
purposes, the provision of public services, and much needed
The programme has established a small team to support pilots
develop detailed devolution asks and form and implement their
business cases, and consider the interplay between devolution
activities and the relevant
Sustainability and Transformation Plans (STPs). The team is
also looking at ways of effectively sharing learning as widely as
Find out more about devolution in London
The team are developing their website and publishing
frequently asked questions and answers to share as much
information about their work as quickly as possible with you. If
you have any other queries or comments, please get in touch (firstname.lastname@example.org).
Q: What does devolution mean for London?
Devolution is a tool to enable health and care decisions to be
made for London, in London. Many decisions about health service
planning and budgets are taken at national level which can
sometimes create unintended barriers to delivering the connected
and tailored local services that Londoners want. Many local areas
have been working to deliver more seamless care to their residents
and health has become increasingly joined up with employment
support, housing and decisions about licensing and planning.
Devolution aims to minimise bureaucracy where possible, providing
new opportunities for Clinical Commissioning Groups and boroughs to
deliver faster improvements and innovations to support Londoners to
be as healthy as possible.
UCL Partners devolution event
UCL Partners Academic Health Science Network (AHSN) recently
hosted an event which looked at devolution as a model for London.
Over 120 stakeholders from local authorities, the NHS, social care,
think tanks, the voluntary sector and academia attended the event
held at City Hall to hear from respected health and care leaders
about what is needed for true integration across health and social
care. Overall, there was a lot of interest and positive feedback
about devolution working in London.
Read the full summary and access slides from the event.
What is LVSC doing?
LVSC's Health Policy Officer and London Health and Care
Devolution's Communications and Engagement Manager have agreed to
help bring together the voluntary & community sector (VCS) and
the pilots on a local (through the local councils for voluntary
services - CVSs) and London wide level. Watch this
Meanwhile, if you are a voluntary, community & social
enterprise sector (VCSE) organisation working with /supporting one
of the London pilots in London, we would love to hear about your
Contact Sandra van der Feen: email@example.com, Health
Policy Officer (Tuesdays and alternate Tue and Wed only)
Useful devolution information for the voluntary &
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