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  1. 1. Better healthcare for London a capital idea
  2. 2. Tackling inequalities
  3. 3. Staying healthy A greater focus on tackling hospital acquired infections Partnerships with organisations and investment in proven health improvement programmes A focus on healthy eating and physical activity - linked to 2012 Games All healthcare staff to promote physical and mental health Improved health protection, especially sexual health and greater support for carers
  4. 4. Maternity and newborn care Early assessment of women’s social and medical needs. Antenatal and postnatal care provided in local one-stop settings Choice of location for birth Continuity of care throughout antenatal, labour and postnatal periods. 1:1 midwife care in established labour Significant increase in the number of midwife-led units Obstetric units should have around 98-hour consultant presence
  5. 5. Children Better co-ordinate care for children with a life- limiting or life-threatening illness Encourage healthy lives Prioritise childhood immunisation People who deal with ill children need to have specialist skills and expertise Provide specialist care for children on fewer sites
  6. 6. Mental health Local treatment, and discussion of whether, as admission to mental health units decrease, inpatient beds are needed in every borough Early intervention and clearer pathways to care Reduce the fear and stigma of asking for help and give service users more control over their lives Services for those most at risk Improving the quality of care and encouraging specialisation
  7. 7. Planned care More specialised inpatient care should be regionalised Shift basic surgery, diagnostic and outpatient services out of major hospitals Better use of day-case procedures Improve community-based services (e.g. GPs for routine appointments before 9am, in the evenings and at weekends, and rehabilitation)
  8. 8. Acute pathway Many current A&E attendees could be treated in the community Major trauma, heart attack, emergency surgery and stroke services should be regionalised A single point of contact (by telephone) for urgent care
  9. 9. End of life Individuals should be supported to express a preference for a place of death A co-ordinator role is needed to ensure patients’ preferences are met All organisations should meet good practice (e.g. gold standards framework)
  10. 10. How we could provide care Working together to provide more accessible, better, safer and more efficient services
  11. 11. Academic Health Centre • An AHSC is a new concept in this country although proven in other countries. • Integrates strategies for service, education and research • Achieved through: – Single mission and a unified governance and management structure • Delivered by: – Creation, utilisation and dissemination of new knowledge
  12. 12. What is an AHSC? • International quality in education, research and clinical services • Strategic and operational alignment of research, education and clinical services, leading to faster translation of discoveries into treatments that benefit patients • Integration of the organisation and its mission with local healthcare provision (not just medical education, research and acute services) • Aligned governance of the academic and service components exemplified by combined leadership for the academic and clinical activities • Integrated operational management at level of delivery
  13. 13. Integrating teaching, research and healthcare provision – demonstrable clinical benefits HSMRs (Hospital Standardised Mortality Ratios): London hospitals vs non-London hospitals (HSMR all England year 2005-6=100) 0 20 40 60 80 100 120 140 2001-02 2002-03 2003-04 2004-05 2005-06 HSMR Inner London Teaching Other London non-Teaching England outside London Source: Dr Foster Unit at Imperial
  14. 14. • On 1st October Imperial College Healthcare NHS Trust was launched through the merger of Hammersmith Hospitals NHS Trust and St Mary’s NHS Trust and integration with Imperial College London. • Integrated board and management team The creation of the UK’s first Academic Health Science Centre