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July 2016
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London Health and Care Devolution
The information below has been largely re-produced from the London Health and Care Devolution team from their first newsletter.
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.
Background
The Kings Fund produced a briefing describing the origins of the devolution agenda should want to find out more.
London
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 and 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 signed the 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 levels."
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
The 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.
The 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
Prevention
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 unemployed.
Integration
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 transformation.
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.
Estates
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 housing.
Programme team
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 possible.
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 ().
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 space....
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 experiences.
Contact Sandra van der Feen: , Health Policy Officer (Tuesdays and alternate Tue and Wed only)
Useful devolution information for the voluntary & community sector
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