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London signs major health devolution deal for five ambitious pilots

London’s CCGs and councils have today signed a historic health devolution deal with the government that will see five pilots launched across the capital focusing on integration, accountable care organisations and asset collaboration.

Today’s major agreement is the first step in a package that includes a longer-term aim for further devolution deals down the line.

As part of this first step, the capital will commit to running five pilots tackling different topics, including:

  • Haringey running a prevention pilot that will use flexibilities in existing planning and licensing powers to develop new approaches to public health problems
  • Barking & Dagenham, Havering and Redbridge developing an accountable care organisation that more closely integrated primary and secondary care, with patient pathways redesigned to focus on early intervention and chronic illness management
  • North Central London (Barnet, Camden, Enfield, Haringey and Islington) running an estates pilot to test new approaches to collaboration on asset use
  • Lewisham seeking to integrate physical and mental health services alongside social care
  • Hackney running a health and social care integration pilot that hopes to fully integrate both budgets and joint provision services, with a particular emphasis on prevention

In line with the aspirations of the NHS Five Year Forward, the five pilots will radically reshape how healthcare is provided across the country’s largest and most complex health economy.

Simon Stevens, NHS England’s chief executive, said: “In London’s NHS, we’ve got some of the best health services anywhere on the planet, but also some of the most pressurised. London is the world’s most dynamic and diverse city – why shouldn’t it be the healthiest?

“Today, the NHS and London local government commit to testing better prevention for our children’s health, to new ways of joining up care for older people, and to shared action to free up unused buildings and land to reinvest in the modern primary care that our fast growing city clearly needs.”

Health secretary Jeremy Hunt and chancellor George Osborne signed the agreement with ‘London Partners’, including all of the capital’s CCGs, local authorities, the Greater London Authority (GLA) and national bodies such as NHS England, Health Education England, NHS Improvement and Public Health England.

Hunt said: “There is a huge amount of good practice and innovation in London health and care services – this exciting new deal will help improve services even further for Londoners.

“The pilot areas we have announced today will be trailblazers as we move towards a fully integrated health and care service by 2020. By empowering more places in the capital to make the best decisions for themselves, we will improve patient experience and help keep people well for longer.”

As part of the deal, the London Partners also agreed to explore the health service’s vast estate in the capital, as well as increase incentives for trusts to make better use of their property.

They will also be given input on government decisions about relief funding for London’s struggling healthcare providers.

Biomedical research boost

Although no overall budget has been dictated in the package, Osborne and Hunt announced a new £800m boost to biomedical research through the National Institute for Health Research during their visit to the Great Ormond Street Hospital today.

The hospital’s biomedical research centre is currently the only one of its kind specialising in paediatrics, but the new funding will be allocated across the full spectrum of health research – including dementia, genomics, cardiovascular, asthma, cancer, nutrition and obesity.

The cash will be provided over five years from April 2017 after the competition is concluded.

Mayor Jules Pipe, chair of London Councils, noted that today’s agreement will also mark the beginning of a real partnership between all public services concerned with the health of Londoners.

“It marks the culmination of much hard work between the boroughs, local clinicians in the CCGs, the NHS, Public Health England and the GLA,” he added.

“Through greater integration of our services, we intend to deliver better outcomes for Londoners to support them in living healthier, independent lives. This agreement provides a strong joint framework for us to deliver that agenda together.”

Despite the country’s recent devolution momentum, London’s agreement is one of the two to focus on healthcare especially, second only to Greater Manchester’s £6bn package finalised earlier this year.

(Top image c. Ray Wewerka)


Barry Davies   15/12/2015 at 14:54

sounds more like another step towards privatisation, The CCG's have proven to be incompetent in purchasing the services needed in their areas and frequently have purchased them to prop up PFI deal hospitals outside their area to the detriment of the people the are supposed to serve. Local councils vary in competence and their own political views can make a huge difference the tory councils are not to be trusted with anything to do with the NHS.

Orky   15/12/2015 at 15:15

Privatisation has been developing in the NHS for years-and it will continue. Why because the NHS can not manage itself efficiently. Failure is rewarded, especially at a senior management basis. NHS England is the health prevention unit in the NHS and it is a massive ineffective bureaucracy. All the NHS will do is constantly ask for more money and not put its house in order and therefore the private businesses will carve out a ever greater proportion.

Cecilia Forster   15/12/2015 at 23:10

Big pay offs for execs incapable of doing the job properly, leaving their post one day only to return in a consultancy role the very next day. If these companies had good results but we see a lot who when push comes to shove could not complete the job they had tended for and got. I see very little in the press of these companies being made to pay back money owed to the NHS as they have not fulfilled their contractual duties. We need to stop health care being farmed out to companies that know little of what is needed for patient care and only consider shareholders profits! Our NHS not yours to sell to the highest bidder!

Orky   16/12/2015 at 09:32

If these private companies do not fulfil the contractual duties why is the NHS paying them. If they did not pay the NHS would force improvement. The NHS simply do not think commercially and therefore are negatively affected. Unless this changes-which it can do with the right leadership-will constantly allow private companies to flourish. If the private companies know so little why are they successful in securing the contracts. The NHS and people within it need to be more business focused. If there is a real desire to keep the NHS is some format it can choose to evolve or be forced. I hope its leadership choose the former.

Cherry Austin   16/12/2015 at 13:27

"The NHS simply do not think commercially" - Why should it? Health provision for profit is entirely foreign to the concept of a universal health service. It is demonstrably harmful to the health of nations. When did "making people well" become a contemptible objective? How does "making shareholders rich" improve the well-being of our people? We all pay for a national health service. Our contract with the NHS and Government is that our payments guarantee best in class health services, free to all at the point of delivery. We have not agreed to replace these objectives with commercial enrichment for private investors.

Sam Mccaffrey   18/12/2015 at 12:51

*THE health secretary, and chancellor George Osborne, signed the agreement... Come on guys, where's the proof reading? :)

Orky   21/12/2015 at 09:30

"The NHS simply do not think commercially-why should it" The simple answer because if it doesn't it's only a question of time and how much the private sector wants to chisel away at. The NHS must get into the real world before the balance is too weighted towards to the private sector. If this is allowed, which is currently the case, a critical momentum will be reached and then it will become extremely difficult to do anything. Whilst I am sure there are many academic theories to support the principal of the NHS the NHS is being faced with business reality and in my view must evolve or not as the case may be. The later will see the emotion for protecting the NHS tested like never before.

Michael   18/01/2016 at 15:49

What I found interesting in reading the agreement is the lack of involvement of patients or the public in the pilots. The exceptions are Harringey where the local Healthwatch are a party to the agreement and Hackney where the Local Healthwatch and the Local VCS organisation are involved. Why is there such a lack of involvement with the people that are supposed to benefit from this and might actually have good ideas as to how to make things better.

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