Health and Social Care Bill

Memorandum submitted by the London Health Forum (HS 37)

1. The London Health Forum is a coalition between the voluntary and private sectors seeking to promote partnership with the statutory sector to improve the health of Londoners

2. Summary: The London Health Forum makes the case for the importance of retaining strategic oversight in London.

3. Section 19 confers power on the NHS Commissioning Board to exercise its functions but is silent on how the Board will operate at sub-national level.

4. The Forum wishes to highlight the importance of retaining strategic oversight in London. This may be exercised by the Mayor in relation to public health. The Forum suggests that it is also important for the NHS to maintain pan-London capability where appropriate.

5. London is affected by particular challenges posed by its demography and geography. The provision of high quality care for London’s mobile and hard-to-reach populations such as asylum seekers, homeless people and ex-offenders is vital to reducing health inequalities with knock-on effects in areas like hospital admissions, all requiring strategic leadership across the capital. The most recent data shows 44% [1] of HIV and 38% [2] of TB cases are in London. HIV and TB, along with other infectious diseases, are not contained within borough boundaries given London’s highly mobile population.

6. The importance of strategic oversight is also essential in delivering high quality acute care, illustrated by the reconfiguration of stroke services in London over the last two years. The introduction of a "hub and spokes" model has pooled funding and expertise where it is most needed and brought about large improvements in performance and outcomes.

7. The London trauma system was launched in April 2010 using a similar hub and spokes model. There are four networks in London and each network has one major trauma unit to treat the most critically ill and local trauma units for those in a less critical condition. The mid-year report published in September 2010 reported that since rationalising trauma care there have been an additional 37 survivors within London compared to the expected number of survivors using national data. [3] It is predicted that the new system will save over 100 lives each year.

8. The Forum would welcome clarification about how the Board will maintain strategic capacity across London as part of its duties under Section 19.

February 2011