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North West London Shaping a healthi
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Table of contents Volume 1 Foreword
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Foreword Dr Mark Spencer The Clinic
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6. Consultation, feedback and how w
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13. Equalities implications This ch
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1. Executive Summary Introduction t
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The overall programme timeline is b
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The process was used before consult
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• Delivery of multi-disciplinary
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Stage 1 - Case for Change Our work
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For Quality of care, clinicians hav
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1 2 3 4 5 A 6 B 7 C 8 Quality of Ca
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Assuring the proposals Throughout t
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Programme implementation arrangemen
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5. To agree that Hammersmith Hospit
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DMBC Chapter 2 - Introduction to th
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2. Introduction to the NHS in NW Lo
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Figure 2.3: Clinical Commissioning
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West Middlesex University Hospital
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major hospital, elective centre and
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DMBC Chapter 3 - Introduction to th
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3. Introduction to the Shaping a he
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3.3 Programme governance The Joint
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The JCPCT is advised by a Programme
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Consultation - during this phase, t
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Ensure consistency of communication
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Stakeholder Group Political Individ
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o o o o o Rationale for options dev
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The implications of the options in
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DMBC Chapter 4 -The Case for Change
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4. The Case for Change This chapter
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Stroke Services: The provision of s
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We need to do more to support patie
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In NW London, however, the NHS is s
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Figure 4.6: Emergency general surgi
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attack or stroke to designated cent
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Figure 4.9: Evaluation of primary c
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Inequalities would continue and pro
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DMBC Chapter 5 - Process for identi
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5. Process for identifying a recomm
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Figure 5.1: Basis of decision of wh
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We confirmed this decision, and the
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5.5 A detailed description of the s
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Correct care setting to deliver hig
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Figure 5.11: Ratings used in evalua
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DMBC Chapter 6 - Consultation, feed
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6. Consultation, feedback and how w
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6.2.1 Key findings from the consult
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times (particularly for patients tr
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Westminster City Council, Adult Ser
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Analysed and considered consultatio
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6.3 Our responses to feedback This
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Feedback received Stakeholders who
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6.3.3 Theme 3: Clinical vision and
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- Page 113 and 114: 6.3.5 Theme 5: Proposals for local
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- Page 119 and 120: Feedback received Stakeholders who
- Page 121 and 122: Feedback received Stakeholders who
- Page 123 and 124: DMBC Chapter 7 - Clinical vision, s
- Page 125 and 126: 7a. Clinical, vision, standards and
- Page 127 and 128: Local clinicians agreed that in ord
- Page 129 and 130: ▪ Expectant mothers should have t
- Page 131 and 132: # Standard care services (111). As
- Page 133 and 134: Figure 7.8: Development of the acut
- Page 135 and 136: # Standard Adapted from source depa
- Page 137 and 138: Figure 7.11: Shaping a healthier fu
- Page 139 and 140: No. Standard Adapted from source Su
- Page 141 and 142: No. Standard Adapted from source se
- Page 143 and 144: # Standard All emergency department
- Page 145 and 146: # Standard All non-urgent - within
- Page 147 and 148: Figure 7.18: Shaping a healthier fu
- Page 149 and 150: # Standard Adapted from source shou
- Page 151 and 152: # Standard Adapted from source Comm
- Page 153 and 154: The final standards are more demand
- Page 155 and 156: Figure 7.26: Proposed services to b
- Page 157 and 158: Each CCG is taking steps to help pr
- Page 159: in major hospitals) and equipment t
- Page 163 and 164: Referral A&E Illustrative patient j
- Page 165 and 166: Illustrative patient journey matern
- Page 167 and 168: Illustrative patient journey in mat
- Page 169 and 170: Illustrative patient journey planne
- Page 171 and 172: GP-led care Illustrative patient jo
- Page 173 and 174: 7.8.1 Scope of the CIG’s work The
- Page 175 and 176: Theme Clinical outcomes Staff attit
- Page 177 and 178: Further stakeholder engagement is n
- Page 179 and 180: Figure 7.31 E&UC CIG Responses to N
- Page 181 and 182: NCAT recommendation CIG response Se
- Page 183 and 184: Conditions suitable for UCC Clinica
- Page 185 and 186: Exclusion criterion Mental health A
- Page 187 and 188: Diagnostics 7.14.3 Streaming, regis
- Page 189 and 190: Biochemistry Microbiology Radiology
- Page 191 and 192: The Provider must deliver appropria
- Page 193 and 194: Figure 7.41: E&UC CIG recommended k
- Page 195 and 196: will be able to establish a service
- Page 197 and 198: The UCC provider will be responsibl
- Page 199 and 200: Key differences Governance As with
- Page 201 and 202: should be provided with appropriate
- Page 203 and 204: Process map 1: Assessing UCC patien
- Page 205 and 206: Process map 3: UCC to ED transfer p
- Page 207 and 208: make an appointment with their own
- Page 209 and 210: 7.19 ED workforce A programme-wide
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The purpose of this section is to s
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Figure 7.45 Consultation results on
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Figure 7.46: Specific Responses the
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NCAT recommendation Original Progra
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7.25.1 London Health Programmes cli
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Future capacity in centralised serv
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3. There would be an additional "st
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in NWL will have a choice of delive
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Support for the proposal is higher
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Figure 7.49: Specific feedback the
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Sub-Theme Organisation Support Conc
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Sub-Theme Organisation Support Conc
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7.36.1 National Clinical Advisory T
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NCAT recommendation Further engagem
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edistributed nationwide. We envisag
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6. The Maternity CIG have considere
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DMBC Chapter 8A-E - Out of hospital
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Out of hospital improvements This c
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8.2. Settings of out of hospital ca
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practical solution for the site, wh
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Brent Health Partnerships Overview
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Consultation theme Standards for ca
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Consultation theme Integration Inve
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8.5.3. Workforce Following feedback
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Delivering this workforce shift wil
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Measure type Domain Potential measu
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8b. Primary care development 8.6. S
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consultation they could have receiv
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8.10. Next steps We are developing
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Figure 8.11: Hub/health centre requ
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some cases, these will be offered o
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Process for development of local ho
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The result is an emerging picture o
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Across NW London, these sites will
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need redeveloping or rebuilding to
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8d. Urgent care centres When indivi
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Figure 8.22: NW London urgent care
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Conditions suitable for UCC Clinica
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Key differences Governance As with
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processes of the CCG and as such th
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around the table accelerates the un
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Improved empowerment - specifically
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Figure 8.28: Realising our integrat
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Figure 8.29: Summary of CCG commiss
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DMBC Chapter 9 - Decision making an
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9a. Decision making analysis stages
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Correct care setting to deliver hig
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“The Brent Health Partnerships Ov
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Correct care setting to deliver hig
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Royal College of Midwives “The RC
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Correct care setting to deliver hig
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clinicians wanted to take this into
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9.6.3 Feedback received about the s
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Confirm the service models reflect
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Figure 9.9: The seven hurdle criter
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surgeons in NW London, but we would
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We confirmed this decision with the
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Appropriate staffing is integral to
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The proposals are supported by Depa
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NW London to deliver high quality c
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1. Support predicting where activit
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Figure 9.15: Example travel time ma
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The analysis shown in Figure 9.18,
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Figure 9.18: Impact on private car
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33% support 10% opposed 57% of peop
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Figure 9.21: Watershed map for blue
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etained as a major hospital, becaus
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9.7.29 The implications of this fee
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Figure 9.25: Potential activity flo
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Figure 9.27: Changes in travel time
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Figure 9.29: Changes in travel time
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Figure 9.31: Possible choices betwe
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Either Charing Cross or Chelsea & W
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Figure 9.33: Option A, excluding ca
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Figure 9.36: Option C responses, in
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Richmond Upon Thames LINk Royal Bor
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Southall Black Sisters “The closu
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Figure 9.38: Ranking of evaluation
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Figure 9.42: Evaluation criteria as
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anked third according to the mean s
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9.9.5 The analysis of the five eval
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Figure 9.45: Quality Dashboard data
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Response to feedback about the eval
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Figure 9.48: Quality of care - Acut
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experience. In order to use this as
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Figure 9.50: Time to major hospital
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Rationalising provision across the
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Figure 9.51: Blue light travel time
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Figure 9.52 shows the reduction in
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3 Value for money 9.9.26 The purpos
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Staff recommendation as a place to
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This analysis was agreed prior to c
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Figure 9.56: Ease of delivering eac
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Response to feedback about implemen
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Changes to the designation of the M
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5 Research and Education: Disruptio
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Figure 9.60: Evaluation of disrupti
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9.9.48 The outcome of the disruptio
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Greg Hands, MP for Chelsea & Fulham
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comprises more than 22 million cita
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Quality/Impact score Figure 9.65 Re
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9. Decision making analysis - stage
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There were six distinct parts of th
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Figure 9.69: 5 year gross savings,
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Figure 9.73: Commissioners intend t
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Figure 9.75: Beds bridge: 2012/13 t
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The key modelling assumptions appli
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Figure 9.79: DMBC NHS net capital e
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Figure 9.81: Approach to estimating
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Figure 9.84: Summary of net surplus
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Figure 9.86: Evaluation of total su
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9.13.9 Impact of the changes: Updat
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Figure 9.89: Effect of the expanded
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Correct care setting to deliver hig
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Sensitivity tests g) Tariff efficie
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Figure 9.93 summarises the impact o
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Figure 9.94: Change in expanded NPV
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The sensitivity analysis supports t
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DMBC Chapter 10 - The recommendatio
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10. The proposed future configurati
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The changes to the scoring before a
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10.3. Why this is the recommendatio
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In the rest of this section, the se