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‘Fundamental’ changes to London’s NHS in wake of COVID-19

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The NHS in London is planning to “fundamentally shift the way we deliver health and care” in the wake of coronavirus, according to documents obtained by HSJ.

The plans from NHS England and Improvement’s London office say leaders should:

  • Plan for elective waiting times to be measured at integrated care system level, rather than trust level.
  • Accept “a different kind of risk appetite than the one we are used to”.
  • Expect decisions from the centre on the location of cancer, paediatric, renal, cardiac, and neurosurgical services.
  • Plan for a permanent increase in critical care capacity.
  • Transform to a “provider system able to be commissioned and funded on a population health basis”.
  • Work towards “a radical shift away from hospital care”.
  • Expect “governance and regulatory landscape implications” plus “streamlined decision-making”.

The document, titled Journey to a New Health and Care System, says there are three “likely” phases, with the final new system in place “from November 2021”.

The preceding two phases are “action programmes” over the next 12 to 15 months which will be about reconfiguring services to deal with “immediate covid, non-covid and elective need”, and “transition” when the move to new configurations is evaluated and “public consent” sought.

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Source: HSJ, 11 May 2020

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Interesting to see the reforms likely to be accelerated by the Covid crisis. Further devolution to London has been anticipated for a long time now. There's a lot of very strong opinions on this development (perhaps a small dose of cynicism, too...), but it is certainly a positive thing for the NHS to develop new models of governance and care that can further be expanded to other parts of the country if successful.

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