Over 1.9 million people live in the eight boroughs that make up east London. Our population is set to rise by around 340,000 over the next 15 years and we need to ensure that we have the resources – people and places – to keep them well and fit for their futures.
We have much in common and some differences. Preventing poor mental and physical health earlier and making the transition between different services and levels of support easier, are two areas of common focus. In Waltham Forest we need to focus on childhood obesity. In Havering, a larger older population need help managing the long-term health conditions we all face, and in Barking and Dagenham life expectancy for women and men is the lowest in London.
What we know is that we cannot contribute to an NHS that is fit for the future and sustainable, affordable social care, unless we work together.
The East London Health and Care Partnership (ELHCP) is one way for us to do that by focusing on the work that it makes sense to do ‘at scale’. Looking at issues like what kind of workforce we need now and in the future, is one example of what can be tackled ‘at scale’, across the whole of east London. But there is much that needs to be done that it only makes sense to address at borough, or local system level.
When we talk about the ‘system’ in east London we are acknowledging not one ‘system’ but a number of them, all contributing to an often complicated and complex pattern of care and health services. Some of these services work well together, some do not.
How are we making long-term plans in east London?
Since 2017 we have been identifying and developing programmes and projects designed to transform the care and health services our communities rely upon. Our geography, common services and workforce has led to the development of local integrated systems that sit within the Partnership.
We have reviewed all of our current plans in the light of the NHS long-term plan and identified any gaps in what we currently do, and what the plan asks us to do in the future. There are some gaps and as we refresh our work programmes and projects there is an opportunity to assess what should be done at a place-based level. We have identified three ‘places’ in east London.
In Waltham Forest, Newham, and Tower Hamlets, Barts Health, East London NHS Foundation Trust, the councils and clinical commissioners will work together in a collaboration known as WEL.
The smallest ‘place’, combines the City of London and Hackney, and one CCG covers the two boroughs and Homerton Hospital. Hackney and the City of London, have a history of working together, but there may be times when it makes sense for them to join-up with neighbouring boroughs.
In Barking, Havering and Redbridge (BHR), where there has been a single CCG for the three boroughs, commissioners in health and care are working with Barking, Havering and Redbridge NHS Trust and North East London NHS Foundation Trust. These three boroughs also have a history of doing some things together.
Working in this way means we can keep our, ‘at scale’ approach for the three ‘enablers’ for sustainable care and health services, and build upon existing relationships. We need the right people, in the right places using the best technology if we want to do more than just create or change care and health services.
Some of the work we’ve planned will need to change. The financial challenges are not evenly distributed, so we are assessing which priority actions we need to take now and how we can stop people from “falling through the cracks” described in the long term plan.
We are starting a more comprehensive conversation with the public about how we can give them more control over the care they receive and support people to stay well. There are different priorities and pressures within health and care services wherever they are provided and working in partnership will not magically solve the issues we face. We are determined to reduce the waste and inefficiency that ‘systems’ can create by being transparent and involving patients, families, carers and staff whenever we can to shape services.
- Councils and the NHS are working to address the health needs of over two million people who live in east London.
- The East London Health and Care Partnership is a way of working that brings these organisations together so we can shape and deliver solutions across health and social care services, making the best use of our resources.
- Partnership does not take control of local services. Instead it is a way of working which brings key services together to tackle the health challenges faced, whether at an East London, or more local level.
Issues we face
- Ensuring sustained improvement in performance against key constitutional standards for both acute (hospital-based services) and mental health.
- Delivering a simplified, streamlined urgent care systems which will ensure the right care, right place, first time access principles for patients and address current performance issues.
- Ensuring ongoing financial sustainability across north east London and supporting the achievement of financial recovery plans for CCGs and providers where these apply.
- Developing a workforce programme that addresses local issues and delivers a sustainable clinical and allied healthcare professional workforce.
- Supporting the delivery of 'Integrated Care Systems' within north east London to drive transformation of care at the local level.