Our Healthier South East London

Our Healthier South East London

Newsletter and Update – November 2014

Welcome to our latest newsletter for partners and the public from the Our Healthier South East London programme. The newsletter will be published at the end of each month on our website and circulated through our Clinical Commissioning Groups.

Overview – Our Healthier South East London

The six local NHS Clinical Commissioning Groups (CCGs) – Bexley, Bromley, Greenwich, Lambeth, Lewisham and Southwark – and the health commissioners from NHS England (London) are working together with local councils and the six borough Health and Wellbeing Boards, hospitals, mental health, primary and community care services, Healthwatch organisations in each borough and local people and patients. We are creating a five-year plan to improve health and services in south east London for everyone. This is the south east London five year commissioning strategy, called Our Healthier South East London.

The strategy focuses on the most important health issues for people in south east London. These are the issues that local senior clinicians, public health and social care staff have identified as top priorities in south east London’s Case for Change. The Case for Change has been discussed and commented on by local people and other stakeholders. It is based on local needs and aspirations and builds on work at borough level, taking into account national and London-wide policies.

The strategy addresses issues that cannot be solved by one area alone or where there is more that can be achieved by working together. It builds on what is currently working well and on local plans, including CCGs’ own borough-wide plans and local Health and Wellbeing Strategies. These will continue to be produced to address borough-specific issues and challenges and they will continue to shape the strategy.

The approach is driven by clinicians and led by the bodies who commission services for the local NHS. It is informed by wide engagement with local communities, patients and the public.

For more information about the programme visit

If you would like to get involved or have any comments or questions, please let us know at:

020 7525 5315

Strategy development progress

A proposal for how different services will work together as a whole – known as a ‘whole system model’ – for the local NHS and care system is being developed by the clinicians, staff, members of the public who attend our meetings, and partners of the programme, such as local councils. This describes how the healthcare system can work and how the different elements of it will fit in together. A first version will be published after Christmas. It will be presented to CCG Governing Bodies at their public meetings in January and will also be shared more widely with partner organisations like local councils, Healthwatch, the voluntary sector and NHS trusts, and with the public.

Clinical Leadership Groups

The content of the strategy is being developed by six Clinical Leadership Groups, one for each of the six priorities for improvementin local healthcare. Each group includes clinicians, commissioners, social care leads and other experts, as well as Healthwatch representatives and patient and public voices from across south east London.

Key headlines from November are:

• The Maternity Clinical Leadership Group has been developing more detail to support the midwifery-led continuity of care model. Under this model each woman would have a named midwife to follow them throughout pregnancy, birth and the postnatal period. The group is also mapping routesfor achieving the nationally-developed London Quality Standards – a set of standards developed to ensure that all hospital-based emergency and maternity services provide care that is safe and of consistently high quality for patients across London, seven days a week.

Our engagement partner Innovation Unit has undertaken two sessions in postnatal clinics with new mothers in children's centres. Twenty five women were interviewed and a range of insights noted. These new mothers emphasised the importance of knowing their midwife/midwifery team through their antenatal care journey as well as highlighting some issues with their postnatal care experience.

• The Children and Young People Clinical Leadership Group has defined its key aspirations, which include access to joined-up care in the community through integrated community children’s teams.Children would be seen and properly assessed at all times. This “no wrong door” policy wouldensure their access to the right services in the right placeand better management of their long term conditions in the community. Members of the group are now discussing outcomes and impacts of the proposed model for future care and have begun defining elements of it; for instance, what is meant by ‘single point of access’.

• The Cancer Clinical Leadership Group has examined ideas for early detection, treatment and transition, cancer related long term conditions and end of life care, toidentify whether these are short, medium or long term pieces of work. These have also been prioritised by their potential impact. Further detail on the many issues to address, timescales for their implementation, the investment required and an estimate of the changes in levels of activity were also discussed.
• The Community Based Care Clinical Leadership Group has been formed by merging the Long Term Conditions and Primary and Community Care Clinical Leadership Groups on the basis that all long term conditions will require community based care at some stage. At the second workshop of this new group, members focused on exploring the new Community Based Care model to be delivered through the development of Local Care Networks, which would bring together primary, community, mental health, social and third sector care. Third sector care is provided by or commissioned from voluntary organisations and charities who may charge for their work, or private organisations commissioned to do work on contract.

• The Urgent and Emergency Care Clinical Leadership Group discussed high impact key ideas during its most recent workshop. These were:
• Urgent Care and Emergency Care services to be available in the same place, with patients being directed to the right department for their needs by an Emergency Nurse Practitioner or other appropriately qualified clinician.
• A rapid response team, whichwould make sure patients who need urgent and emergency care receive the treatment they need in the right place at the right time (including in their own homes) and would support the rapid return of patients to their homes, moving back to local health and care services outside hospital
• Local Care Networks, which will have extended opening hours, linking to rapid access services to support the frail, elderly and those patients with long term conditions
• Mental health liaison services to work within the Local Care Networks for patients in crisis - for example, patients using or requiring perinatal, drugs and alcohol, children and young people’s and older people’s and dementia services.

For each of these ideas, the possible obstacles to implementation and the ways in which we could support change were discussed, as were the cost implications and activity changes needed. This work will be used to develop the proposed Urgent and Emergency Care model.

• The Planned Care Clinical Leadership Groupin its latest workshop has developed outcome measures across the health of the population, quality of care, quality of life, and effectiveness of care.

The group is focused on three key areas – standardisation, diagnostics, and elective care models. These were reviewed to identify opportunities, obstacles, the additional investment required and potential benefits.

Engagement update

Patient and Public Advisory Group (PPAG)

PPAG held its fourth meeting on Monday 27 October, where the group elected John King as Chair. Other key elements of the meeting were:

• PPAG agreed to develop an action plan to implement feedback to the programme, including adjusting language and providing more opportunities for patient and public voices to contribute to meetings, improving their accessibility.
• In order to develop a deeper understanding of the strategy and how their clinical areas fit into the whole picture, two PPAG information workshops are being organised for December, each focusing on three Clinical Leadership Group areas.

In order to get more involvement from children and young people in the programme, we are looking at different methods toengage with them, , including taking the ideas behind the strategy out to people/families in their own areas.

Wider engagement

A programme of engagement is underway, run by our partner Innovation Unit, who are experts in public engagement. The engagement focuses on testing the thinking coming from the Clinical Leadership Groups to see how it fits with the issues which matter to people. This is a mixture of drop-in sessions, in-depth interviews and stakeholder events intended to reach a wide range of people across all six boroughs.

The first events held were children’s and young people’s drop-in sessions in Lewisham Hospital’s paediatric outpatient department and at a mother and baby group in Lewisham. Further sessions in other boroughs and with different populations are planned, including three workshops covering all six boroughs during December.

The objectives of these three December workshops are to gather insights from the local community to feed back to the Clinical Leadership Groups. Specifically, this aims to capture people’s current experiences, to explore what is most important to them when they access services and to understand the implications of the suggested changes on people’s experiences. Our PPAG is working with Innovation Unit on the development and presentation of these events.

Information about these events is available at

Forthcoming milestones

A progress report will be published in January to inform Clinical Commissioning Group Governing Bodies, partners and the public about the current status of the strategy, the proposed whole systems model, mentioned above, and the individual models of care being developed and considered by each Clinical Leadership Group.