Chantler2008

Better healthcare for London a capital idea

Tackling inequalities

Staying healthy

A greater focus on tackling hospital acquired infections

Partnerships with organisations and investment in proven health improvement programmes

A focus on healthy eating and physical activity - linked to 2012 Games

All healthcare staff to promote physical and mental health

Improved health protection, especially sexual health and greater support for carers

Maternity and newborn care

Early assessment of women’s social and medical needs. Antenatal and postnatal care provided in localone-stop settings

Choice of location for birth

Continuity of care throughout antenatal, labourand postnatal periods. 1:1 midwife care in established labour

Significant increase in the number of midwife-led units

Obstetric units should have around 98-hourconsultant presence

Children

Better co-ordinate care for children with a life-limiting or life-threatening illness

Encourage healthy lives

Prioritise childhood immunisation

People who deal with ill children need to have specialist skills and expertise

Provide specialist care for children on fewer sites

Mental health

Local treatment, and discussion of whether, as admission to mental health units decrease, inpatient beds are needed in every borough

Early intervention and clearer pathways to care

Reduce the fear and stigma of asking for help and give service users more control over their lives

Services for those most at risk

Improving the quality of care and encouraging specialisation

Planned care

More specialised inpatient care shouldbe regionalised

Shift basic surgery, diagnostic and outpatient services out of major hospitals

Better use of day-case procedures

Improve community-based services (e.g. GPs for routine appointments before 9am, in the evenings and at weekends, and rehabilitation)

Acute pathway

Many current A&E attendees could be treated in the community

Major trauma, heart attack, emergency surgery and stroke services should be regionalised

A single point of contact (by telephone)for urgent care

End of life

Individuals should be supported to expressa preference for a place of death

A co-ordinator role is needed to ensure patients’ preferences are met

All organisations should meet good practice (e.g. gold standards framework)

How we could provide care

Working together to provide more accessible, better, safer and more efficient services

Academic Health Centre

• An AHSC is a new concept in this country although proven in other countries.

• Integrates strategies for service, education and research

• Achieved through:– Single mission and a unified governance and management

structure

• Delivered by:– Creation, utilisation and dissemination of new knowledge

What is an AHSC?

• International quality in education, research and clinical services• Strategic and operational alignment of research, education and

clinical services, leading to faster translation of discoveries into treatments that benefit patients

• Integration of the organisation and its mission with local healthcare provision (not just medical education, research and acute services)

• Aligned governance of the academic and service components exemplified by combined leadership for the academic and clinical activities

• Integrated operational management at level of delivery

Integrating teaching, research and healthcare provision – demonstrable clinical benefits

HSMRs (Hospital Standardised Mortality Ratios): London hospitals vs non-London hospitals (HSMR all England year 2005-6=100)

0

20

40

60

80

100

120

140

2001-02 2002-03 2003-04 2004-05 2005-06

HS

MR

Inner London Teaching

Other London non-Teaching

England outside London

Source: Dr Foster Unit at Imperial

• On 1st October Imperial College Healthcare NHS Trust was launched through the merger of Hammersmith Hospitals NHS Trust and St Mary’s NHS Trust and integration with Imperial College London.

• Integrated board and management team

The creation of the UK’s first Academic

Health Science Centre