SaHF DMBC Volume 1 Edition 1.1.pdf - Shaping a healthier future

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1. Executive Summary
This section provides a summary of the decision making business case (DMBC).
2. Introduction to NHS NW London
This chapter describes the shape and structure of the NHS in North West (NW) London and
how the local commissioners ensure that the two million people who live here receive the
community, acute, mental health and specialist services they need.
3. Introduction to the Shaping a healthier future and the purpose of this
document
This chapter describes the work that preceded the Shaping a healthier future programme
and how the programme was established. It discusses the underlying principles of the
programme and how the programme’s governance and timeline were established to support
those principles. The programme has worked extensively with clinicians, the public, patients
and other stakeholders on proposals to transform the health system in NW London and
select a recommendation. The chapter concludes with a description of how this business
case provides the information necessary for the Joint Committee of Primary Care Trusts
(JCPCT) to make an informed decision about reconfiguration in NW London.
4. The Case for Change
This chapter describes why change is necessary and why it must start now. The NHS in NW
London is facing a range of pressures and challenges. From a clinical view, there is
increased demand caused by the ageing population and increased prevalence of long term
conditions and co-morbidities. There are also unacceptable variations in the quality of care
provided, evidenced by higher mortality rates for patients who are treated in hospital at night
or during the weekend. Alongside this, there are financial pressures which require the NHS
to deliver efficiency savings for reinvestment. As such, doing nothing is not an option. The
Case for Change was developed by clinicians, who looked at the current and future
demands on the NHS in NW London, and showed that a new configuration of services was
necessary to deliver high quality care within the financial constraints on the system.
5. Process for identifying a recommended option
This chapter describes how we identified a recommendation for reconfiguration of hospital
services in NW London using a seven stage process. There are millions of options for the
configuration of services if all the combinations are considered. Therefore we developed a
process that uses seven stages to consider all the available options systematically, to
develop a shortlist of options and to enable us to carry out in depth analysis on that shortlist.
We used the process before consultation to identify options to consult on. During
consultation we received feedback about the process and we used this feedback to reevaluate
the process. We then reconfirmed with our stakeholders that the process remained
appropriate for use to identify the recommended reconfiguration option.