We want to improve the health of the people of north east London and we want to make sure people receive high quality healthcare services.
There have been considerable achievements in the last few years in improving services, for instance in reducing waiting lists and increasing survival rates for cancer and coronary heart disease. However, residents continue to have higher levels of ill health and shorter life expectancy than residents of other areas of London and England.
We want more services to be provided close to where people live whenever possible. At the same time clinicians believe that we need to provide some more specialist services from fewer locations, in centres of real expertise. This is so that people needing specialist care receive the best possible support from the right professionals in the right place at the right time.
There are six key reasons for making changes to the way we deliver healthcare in north east London:
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We need to improve the health of people in north east London and ensure healthcare services are meeting public expectations
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The population of north east London is rising rapidly leading to greater demand on health services
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Patients benefit from care closer to home and more care can be delivered in community settings than ever before – so hospital treatment is not always the answer
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Current services are under severe pressure and there are staffing challenges which prevent the NHS delivering the best quality care
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New ways of providing care can deliver better treatment for patients
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We need to make better use of taxpayers’ money.
1. Need to improve the health of people in north east London
North east London is facing a bigger health challenge than any other London area.
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The local population has a lower life expectancy, with higher rates of infant death and higher mortality rates from cancer and cardiovascular disease than other London sectors.
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There is a high incidence of long term conditions such as diabetes, chronic obstructive pulmonary disease (COPD), hypertension and cardiovascular disease as well as high rates of mental illness and infections such as tuberculosis (TB) and HIV.
Overall the NHS in north east London performs poorly on mortality rates, patient satisfaction and performance targets such as waiting times.
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2. Rising population leading to greater demand on services
North east London has a higher than average birth rate; demand will soon exceed capacity.
There will also be increased burden on the NHS for treatment of long term conditions. Improving health means not only treating illness effectively, but also preventing ill health. Providing early treatment in the community can improve the health of the community.
To find out more about what your local PCT is doing to prevent ill health and support people manage long term conditions you can visit their website.
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3. Hospital is not always the answer
North east London has very high rates of A&E attendances and admissions yet many of these patients would be better served by primary care practitioners e.g. family doctors.
Clinical advances mean that more care can be provided locally than ever before. For instance, modern surgery allows more procedures to be safely delivered as day cases, outside of major hospital settings.
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4. Workforce challenges
Workforce challenges such as high staff turnover, prolonged vacancy rates, low staff utilisation and high sickness rates currently prevent delivery of the best quality care and optimal patient outcomes. Vacancy rates are, in part, due to national shortages of some clinical staff groups like paediatricians, midwives, radiologists and pathologists however, insufficient numbers of staff are choosing to work in north east London.
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5. New ways of providing care can deliver better treatment for patients
North east London need to better use its skilled workforce to provide 24/7 senior clinical cover. This would help to ensure early decision making and would lead to better quality and safety of care.
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6. Need to make best use of taxpayers' money
We need to improve productivity and efficiency to ensure that we provide the best value for money. Savings can be made from reducing fixed costs and overheads; avoiding unused clinical space (were money is spent to heat, light, clean and maintain buildings even though they are not fully utilised); by separating emergency and planned care; better surgery (reducing readmissions) and processes; and reducing lengths of stay.
Patients in north east London stay in hospital longer than other patients around the country. Patients prefer to be at home (they often recover better there) and it is also less expensive.
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Case for change
The 2009 clinical case for change: Making Healthcare for London Happen in North East London was presented to the joint committees of PCTs on 24 November 2009. Click here to read.
An updated clinical case for change, along with the final clinical proposals, was presented to the joint committees of PCTs on 15 December 2010 as part of the Decision Making Business Case (DMBC). Click here to read the DMBC.
