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Improving health and health care in London: Who will take the lead?


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John Appleby introduces The King's Fund's report on health and health care in London, considering who will lead improvements and reform after Healthcare for London.

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Improving health and health care in London: Who will take the lead?

  1. 1. Improving health and health care inLondon: Who will take the lead?John ApplebyChief Economist, The King’s FundDecember 2011
  2. 2. Old reports:• London health care 2010:Changing the future of services inthe capital, The King’s Fund• Transforming health in London,The King’s Fund• Metropolitan Hospitals,Provident and Other PublicDispensaries and CharitableInstitutions for the Sick Poor,House of Lords Select Committeereport New report published in December 2011
  3. 3. 120 years of reviews ofLondon’s health services
  4. 4. Healthcare for London:A Framework for ActionLord Ara Darzi, 2007
  5. 5. London PCTs 2011/12 allocation
  6. 6. London trauma centres
  7. 7. Summary indicatorsGP patient survey 2010• London ranks bottom on 26 out of 31 patientexperience measures of primary care
  8. 8. Current multi-site trusts and proposed mergers
  9. 9. ‘Compared with the other nineregions, London has the lowestproportion of trusts that have achievedfoundation trust status (38 per cent),and the highest number of trusts (26)still in the pipeline. The SHAs wespoke to in other regions agreed that,while some individual trusts in otherparts of the country face similarproblems, the concentration andcomplexity of challenges in Londonare not replicated elsewhere.’National Audit Office (2011). Achievement ofFoundation Trust Status by NHS Hospital Trusts.Report by the comptroller and auditor general HC(1516) (2010–12).
  10. 10. Four options for taking forward change in London: 1: Patient choice and clinical commissioners leading change in a market 2: The NHS Commissioning Board leading change through planning 3: Local authorities leading change through health and wellbeing boards 4: Providers leading change through academic health sciences partnerships
  11. 11. ‘...nothing in the Bill explains howstrategic change will be made to theNHS. With perhaps 300 consortia,how will the necessary changes bemade on a regional level? Theprogramme that I led, Healthcare forLondon, built an alliance of hundredsof clinicians and managers across thecapital to improve care. It led toLondon becoming the world leader instroke and cardiac care... How willsimilar improvements happen infuture?’Darzi, 2011 Speech, Second reading of the Healthand Social Care Bill, House of Lords: Hansard 11Oct 2011, Column 1493
  12. 12. Read the reportImproving health and health care inLondon: Who will take the lead?