London Health Libraries Induction

15th September 2008

The NHS in London

Mandy GuestKnowledge Service ManagerIslington Primary Care Trust

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London 7.6 million population with 200 communities and 300 languages spoken

• 250,000 health and care staff

• 32 London Boroughs

• Mayor + London Assembly = Greater London Authority

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• the Strategic Health Authority (SHA) for London•plans healthcare for the population•responsible to the Department of Health

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NHS London is

NHS Trusts• 31 PCTs• 25 NHS Trusts (Acute hospitals)• 3 Mental Health Trusts• Ambulance service Trusts• (14 Foundation trusts (including 7 mental

health) operate more independently and are regulated by Monitor)

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Primary Care

Primary care includes:•GP practices•Dentists, Opticians, Pharmacists•District Nursing and services in the local community

•Physiotherapy, podiatry, speech and language therapy etc

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Primary Care Trusts

• Primary Care Trusts (PCTs) are in charge of primary care and have a major role around commissioning secondary care, providing community care services.

• PCTs are at the centre of the NHS and control 80% of the NHS budget. As they are local organisations, they are best positioned to understand the needs of their community.

Commissioning

• Practice based commissioning• World Class Commissioning• Specialised services commissioning

Adding life to years and years to life

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Secondary and Tertiary care

• Hospitals managed by 13 Foundation Trusts and 24 Acute Trusts •Mental Health Trusts •Ambulance Trust•Specialised services

• Other providers for NHS patients including nursing homes

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•Secondary care is known as acute health care and can be either elective care or emergency care.

•Elective care means planned specialist medical care or surgery, usually following referral from a primary or

community health professional such as a GP.

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Secondary care

Framework for London

• Framework for London July 2007 (Darzi) – details how London's healthcare needs to change

over the next ten years – 5 principles:– Services should be focused on individual needs and

choices – Services should be localised where possible and

regionalised where that improves the quality of care – There should be joined-up care and partnership

working, maximising the contribution of the entire workforce

– Prevention is better than cure – There must be a focus on reducing differences in

health and healthcare

Framework for Action

• 3 month consultation, ended 7th March 2008• Roadshows etc• In mid-2008, a committee of PCTs considered

the report and used it to make decisions on the issues being consulted upon.

• Based on these decisions, the PCTs developed detailed proposals on services

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Specialist care

• Specialist centres will treat patients who have suffered a stroke or major trauma. 

• Around seven specialist stroke centres, and between three and six major trauma centres, will be developed. 

• Specialist care for children, and those who need complex emergency surgery, will also be delivered in dedicated units.

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Care closer to home• Patients with ‘long-term conditions’ such as diabetes and

arthritis will be able to access more care locally, and be supported to better manage their conditions. 

• More outpatient care, tests and minor procedures will be provided in the community, meaning fewer visits to hospital.  Londoners will also have better access to GPs

out of hours • Polyclinic models will offer better services at more

convenient times, by linking GP and other services

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Any questions?