Strategic Health Authority (Supplementary) [3]

Professor the Lord Darzi (Chair, London Health Commission):  You have thrown a large number of questions there, which in many ways I did touch on before. 

Firstly to say we do have a NHS England office in terms of managing the estate.  Coming back to the stroke and trauma, that was the output of London: A Framework for Action.  The people who made that change were the clinicians on the ground.  It was not a Strategic Health Authority who banged heads around and made sure that it was happening. 

Joanne McCartney AM (Chairman):  Where is that city-wide oversight in future?  Where is the accountability?

Professor the Lord Darzi (Chair, London Health Commission):  It is a different world.  It is not just health.  It is not just one organisation called the Strategic Health Authority.  It is a different world.  It is a world in which local government has a big say and boroughs have a big say in what happens at a local level.  It is a bit like saying, “Who is going to co-ordinate the 32 boroughs?” 

Joanne McCartney AM (Chairman):  There is.  It is London Councils.

Professor the Lord Darzi (Chair, London Health Commission):  We are seeing clusters of CCGs in certain parts, coming in and working together.  I absolutely agree with the question.  I am trying to find out does that actually give the following answer is the issue.  I still have four months to think about this.

Simon Weldon (Regional Director of Operations and Delivery, NHS England (London)):  I would add to that, to think that 32 CCGs sit in splendid isolation and do not talk to one another is, of course, not the case.  They collaborate together all the time.  Look at north west London.  The eight CCGs have worked entirely together to deliver Shaping a Healthier Future.  That is not something that could be led by one CCG.  It is something that has been led by them altogether.  Look at the South East London CCGs.  Despite the issues around the Trust Special Administrator process, what was really evident in that was that the CCGs came together to provide leadership for their local community, and try to make the best of what they found in that process. 

The fact is that CCGs are working together, not only in their local systems; they are developing much stronger relationships.  When I ask CCGs what has been a big benefit of the new system, they say they have immeasurably strengthened their relationships with local government.  That has been a real benefit for them.  They would absolutely own to that.  They also recognise that to get some of the changes that they need to happen, they are going to have to work together. 

The second point I would make is that they are often collaborating together around clinical standards and around how they set frameworks to make sure that clinical care, when it is delivered, like we did with stroke, like we did with trauma, is delivered in the same way across London.  We work with them regularly as a group, right across London, to deliver that.  We are embarking upon a piece of work, for example, to look at how we can improve the quality of mental healthcare; again, doing that collaboratively between NHS England and the CCGs.