North West London Health and Care Strategy

We know that in some areas and communities in North West London people have poorer health than in others. The conditions in which we are born, grow, live, work and age can impact our health and wellbeing. Health inequalities are unfair differences in health across the population and between different groups within society. These include how long people are likely to live, the health conditions they may experience and the care that is available to them.

We are working to improve the health of everyone in North West London, no matter who they are. This work involves local people, the NHS, and other public services including councils, schools, housing associations and social services working together. We understand the need to work within communities to identify groups with poorer outcomes and provide solutions which address the issues that matter most to them. This includes a wide range of groups such as asylum seekers, people experiencing homelessness, specific ethnic minority communities and unpaid carers.

Working in collaboration helps us build services that meet the needs of people in each area, improve people’s health, prevent illnesses, and make better use of public resources. All of our plans have been informed by our ongoing community engagement. You can read our regular insight reports in the Get involved pages.

Our plans to reduce inequalities in North West London over the next five years include:

• Making sure we have a clear understanding of the health of our population, including the differences between population groups and how many people have health conditions.
• Improving access to care, experience of care and health outcomes for more vulnerable people - those who experience homelessness and asylum seekers.
• Working in partnership to improve access to education, training and employment opportunities for our most disadvantaged communities.
• Examine data to understand the impact of being an unpaid carer in North West London and how we can work together to support all carers and volunteers.
• Working with public health partners to keep our communities healthy to reduce high blood pressure, reduce smoking rates, increase healthy weight initiatives and support our youngest residents to have a better start in life and empower people to engage with their own health and wellbeing.

We all have mental health – it’s about how you feel on any given day. If you have a mental health problem, it can impact how you think, feel and behave.

We know that more people, and increasingly younger people, need help and support from mental health services.

We are working with people who use mental health services and those with learning disabilities and autism, to develop the right support for people and making sure it is in the right place for them.

All of our plans have been informed by our ongoing community engagement. You can read our regular community insight reports on the Get involved pages.

Our plans over the next five years to improve mental health outcomes in North West London include:

• Putting more mental health support teams in schools.
• Creating more local (non-clinical) spaces for people to access help and support, for example adult community mental health services.
• Continuing to integrate community mental health services (adults and children's) into local ‘neighbourhood’ teams. Continuing to improve community based services for autistic people with learning disabilities to further reduce the reliance on hospital (inpatient) beds.
• Promoting alternatives to A&E for those in crisis, including expanding 24/7 helplines and linking these to 111.
• Providing appropriate therapeutic spaces to support people in crisis.
• Improving communication and support for people waiting for assessment and  care.

This work looks at care and support provided in the community rather than a hospital, including support in your own home.

We understand how important it is to have good, timely, access to you health and care teams. We will be working to improve your access to these services, including your GP, and provide flexible support which meets the different needs of our diverse communities.

This work covers residents of all ages and supports better care for people who are ‘mostly healthy’ and people with complex and long standing health conditions.

All of our plans have been informed by our ongoing community engagement – You can read our regular community insight reports on the Get involved pages and also targeted engagement updates for people with complex needs, such as at the end of life.

Our plans to improve local care in North West London over the next five years include:

• Creating ‘neighbourhood’ teams for local communities of roughly 50,000 people with the NHS and local councils working in partnership to support residents with their health and care needs. GP services are at the heart of these ‘neighbourhood’ teams and include other NHS services such as physio or nursing in patient’s own homes.
• Improving access to your GP and wider services. Primary care to continue to embrace digital technology, using e-consultations to triage patients and offer multiple options for appointments including face to face, video or telephone.
• Talking to the public about how and where services are provided and how they can be best accessed, when care ‘on the day’ is needed – including digital and remote support where this works well for individual patients.
• Improving the early planning and the support people receive at the end of their life.
• Identifying earlier when people have a long term condition such as diabetes or hypertension and then making sure the best treatment plan is in place based on what the individual wants. When people do need a stay in hospital making sure they return home quickly and safely (including if their home is a care home) with the ongoing support they and their family or carers, need.

This is care that is provided in a hospital. We know that patients are now waiting longer for emergency and planned care.

This work looks at improving access to specialist care and improving how we provide urgent and emergency care such as our A&Es and urgent treatment centres (UTCs).

All of our plans have been informed by our ongoing community engagement. You can read our regular community insight reports on the Get involved pages.

Our plans to improve acute care in North West London over the next five years include:

• Making sure residents have timely access to specialist doctor’s expertise whenever they need it.
• Reducing waiting times for surgery.
• Making sure residents have convenient and timely access to diagnostic tests, including x-rays and scans.
• Improving urgent and emergency care to reduce delays.
• Making sure residents experience the same quality of care regardless of where they receive it. 

Cancer is an illness which affects many people over their lifetime. There are many different types and it is important that we are able to find out about it early.

We know that there is inequality in people who go for their free NHS cancer screening. Waiting times to see a cancer specialist are also longer than they should be.

All of our plans have been informed by our ongoing community engagement. You can read our regular community insight reports on the Get involved pages.

Our plans to improve cancer care in North West London over the next five years include:

• Making sure patients are seen within two weeks of a GP cancer referral.
• Finding cancers earlier through education sessions, standardising referrals and developing new interventions.  
• Improving health outcomes by improving follow-up care for patients.
• Working with our partners and community groups to encourage residents with possible cancer symptoms to contact their doctor earlier.
• Working with our community to better understand the reasons why some people do not attend free NHS cancer screenings.

We know that there are differences in how healthy children are in North West London.

That can be for many reasons including because of where we are born, live and grow. Children from more deprived backgrounds will often have poorer health and we want to change that.

This work looks at providing support for families in North West London and working with communities to improve the health of our children and young people.

All of our plans have been informed by our ongoing community engagement. You can read our regular community insight reports on the Get involved pages.

Our plans to improve care for babies, children and young people in North West London over the next five years include:

• Working with NHS providers to ensure the transition from child to adult services is delivered to a consistent standard and included in special educational needs (SEND) local offers.
• Developing child health and family hubs and making sure the core services they provide are the same across North West London. These local hubs will be part of ‘neighbourhood’ teams and provide services from the NHS, local authority and voluntary care services.
• Working with families, children and young people to design services that meet their needs, especially in areas where we see the biggest differences in health.
• Working with Imperial College London and The School of Public Health to use the latest innovations to better care for our patients.
• Working with families to understand the reasons why some are not up to date with  vaccinations. Improving the health of children’s teeth.
• Making sure that families and children will feel listened to and at the centre of making decisions for their care. 

This work looks at the care you and your baby receive during pregnancy.

We know that there is more we can do to improve the experience, quality and safety of care for mothers and partners across our maternity services.

We want to support our midwifery workforce and develop new ways to support mothers and their families in our care.

All of our plans have been informed by our ongoing community engagement. You can read our regular community insight reports on the Get involved pages.

Our plans to improve maternity and neonatal care in North West London over the next five years include:

• Setting up new pre-term birth clinics to help reduce the number of babies born early.
• Supporting staff with improved training opportunities and continuing to recruit new staff into maternity and neonatal services.
• Making maternity and neonatal services more efficient with better use of digital tools for parents and families, for those who can use them e.g the North West London Mum and Baby app.
• Joining services together where it will mean we can better support patients.
• Working with Maternity and Neonatal Voice Partnerships to make sure we have maternity and neonatal champions to be the voice of the patient and support our family.
• Integrating maternity services into family hubs to better support families.
• Working with our communities to understand how midwifery and neonatal services need to be different to support the needs of different groups.
• Prioritising continuity of care for those who will benefit most - Black, Asian and mixed ethnicity women, and women from our most deprived areas of North West London.

Hearing from our residents across North West London is so important. We want to have NHS services that work for you and we can’t do that without your help. Our communities want to be listened to and involved in the development of their local health services.

This work looks at how we will work with local people and use their feedback to improve and develop services, much like how we have worked with our residents to develop this strategy overall.

All of our plans have been informed by our ongoing community engagement. You can read our regular community insight reports on the Get involved pages.

Our plans to involve our local communities in North West London over the next five years include:

• Regularly asking ‘what matters to you’ as we listen to all our communities across North West London.
• Placing as much importance on what we hear from our residents and populations as we do with other data.
• Working with grassroots voluntary sector organisations and residents to build trusted relationships with our communities.
• Designing future plans in partnership with people and communities.
• Empowering people to take control of their own health and increase confidence in managing long term conditions.
• Making sure our residents have a voice in all our work.

Using technology is not something that everyone wants to do, or can do. However, for many people, new technology can support their health - for example to help keep them out of hospital by monitoring and managing health from home.

We know we have work to do to update our IT systems to improve efficiency. This work looks at how we can make better use of technology to support patients and health and care staff, to improve care.

All of our plans have been informed by our ongoing community engagement. You can read our regular community insight reports on the Get involved pages.

Our plans to further develop our use of data and digital technologies in North West London over the next five years include:

• Using new and innovative technologies to improve and support clinical decision making.
• Creating new ways to provide care using advances in technology, for example virtual wards and home monitoring.
• Developing a single dataset of timely, detailed health and care information, that can help clinicians provide the right care and support for patients.
• Developing systems to provide a North West London wide overview and management of demand, capacity and patient flows across hospitals and primary care services.
• Automating advice and guidance from clinical specialists to support GPs with referrals. Implementing shared records, so all clinicians supporting the health and care of an individual can see their information.
• Standardising clinical systems across hospitals and care settings, to allow all our hospital systems to talk to each other.
• Reducing the need for patients to repeat information at each appointment.
• Where possible, help residents whose first language is not English by providing information via digital systems in multiple languages.

We know that recruitment and retention of staff in health, is becoming more challenging.

This work looks at how we can better support staff through training and new ways to provide care with new job roles that benefit both staff and patients.

All of our plans have been informed by our ongoing community engagement. You can read our regular community insight reports in the Get involved pages.

Our plans to improve support for our workforce in North West London over the next five years includes:

• Creating flexible career pathways across all the organisations within the North West London Integrated Care System.
• Addressing racism and developing inclusive practices and culture.
• Improving staff wellbeing and providing better support.
• Doing things differently - looking at hard to recruit roles and redesigning models of care to make services and roles better for staff and patients.
• Working with primary care and social care to develop joined up workforce plans.
• Making sure effective education and training programmes are in place to deliver future ways of providing care, new roles, and new apprenticeships through a North West London Health and Social Care Skills Academy.

This looks at the building space we have in North West London. It is everything from hospitals and GP surgeries to local clinics and offices.

We know that some of our buildings are not fit for purpose and that it is not all being used as effectively as it could be. This work looks at how we can improve environments and better use our spaces to provide care.

All of our plans have been informed by our ongoing community engagement. You can read our regular community insight reports on the Get involved pages.

Our work to improve our use of buildings in North West London over the next five years includes:

• Working together with clinical programs and stakeholders to develop proposals to make estate fit for purpose now and for the future.
• Progressing the developments of two new hospital builds for Hillingdon and Imperial hospitals.
• Making better use of empty spaces and using space efficiently.
• Working together across ICS organisations to use space collectively.
• Reviewing all leases in primary care to better serve local communities through primary care hubs supporting local ‘neighbourhood’ teams.

We know that recruitment and retention of staff in health, is becoming more challenging.

This work looks at how we can better support staff through training and new ways to provide care with new job roles that benefit both staff and patients.

All of our plans have been informed by our ongoing community engagement. You can read our regular community insight reports in the Get involved pages.

Our plans to improve support for our workforce over the next five years includes:

• Creating flexible career pathways across all the organisations within the North West London Integrated Care System.
• Addressing racism and developing inclusive practices and culture.
• Improving staff wellbeing and providing better support.
• Doing things differently - looking at hard to recruit roles and redesigning models of care to make services and roles better for staff and patients.
• Working with primary care and social care to develop joined up workforce plans.
• Making sure effective education and training programmes are in place to deliver future ways of providing care, new roles, and new apprenticeships through a North West London Health and Social Care Skills Academy.

We know that there is more we can learn and there are better ways to prevent and diagnose disease earlier.

This work looks at how we can improve the health of our patients by being more ambitious with the research we undertake.

All of our plans have been informed by our ongoing community engagement. You can read our regular insight reports in the Get involved pages.

Our plans for research and innovation in North West London over the next five years inlcude:

• Concentrating our research effort on fewer areas to support the adoption and roll out of new methods of prevention and treatment. These include:
  • Maximising the experience and outcomes for residents with chronic disease, by preventing, diagnosing and better treating patient needs.  This work will start by looking at cardiovascular disease.
  • Minimising the harm suffered by patients being in the wrong care setting.
  • Ensuring that children and young adults have the best start in life, with a particular focus on promoting positive mental health.
• Supporting and incentivising how research and innovation works across, and improves the lives of, all our communities in North West London.