London devolution deal paves the way for radical NHS transformation

Chancellor George Osborne and Health Secretary Jeremy Hunt signed the agreement with ‘London partners’ including all of London’s CCGs, local authorities, the Greater London Authority and national bodies including NHS England, Health Education England, NHS Improvement and Public Health England.

A similar deal was signed in February for Greater Manchester, resulting in a single £6 billion budget for health and social care across the region.

The London agreement was signed on 15 December at the Great Ormond Street Hospital and will begin with five new integration pilots which will be rolled out across the capital. The areas trailing the scheme include: Barking & Dagenham, Havering and Redbridge in north east London, where a new accountable care organisation (ACO) will integrate primary and secondary care and redesign patient pathways with a focus on early intervention and managing chronically ill patients; Lewisham will run a pilot seeking to integrate physical and mental health services alongside social care; Haringey will trial a prevention pilot which will use planning and licensing power to develop new approaches to public health; Hackney will run a health and social care integration pilot, aiming for full integration of health and social care budgets and joint provision of services; Barnet, Camden, Enfield, Haringey and Islington will run an estates pilot testing new approaches to collaboration.

The five pilots will be used to develop new care models that can be used long term, to further devolution of control to local health and civic leaders.

The new plans will look to explore local flexibilities on payment and tariff mechanisms, by testing and developing mechanisms which could see integration of primary care budgets with those of other services.

Osborne said: “Today’s agreement is another crucial step in our devolution revolution and is the start of us handing over valuable healthcare power to local leaders in London.

“This deal means that not only will the people of London have more control over decisions that affect their lives, it will also lead to better, more joined up healthcare in the capital for Londoners.”

Hunt commented: “This exciting new deal will help improve services even further for Londoners. The pilot areas we have announced today will be trailblazers as we move towards a fully integrated health and care service by 2020.

“By empowering more places in the capital to make the best decisions for themselves we will improve patient experience, and help keep people well for longer.”

Mayor of London Boris Johnson said: “This agreement paves the way for a revolution in how health and social care are delivered across the capital. With our city’s population continuing to grow, it is essential that we have a health service better equipped to manage its own resources so that it can become even more responsive to the needs of Londoners.”

NHS England chief executive Simon Stevens said: ‘“Today the NHS and London local government commit to testing better prevention for our children’s health, to new ways of joining up care for older people, and to shared action to free up unused buildings and land to reinvest in the modern primary care that our fast growing city clearly needs.”

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