Devolution for health and care in London

The principles for London devolution were set out in the London Health and Care Collaboration Agreement, signed in December 2016 by key stakeholders including Dr Marc Rowland, Chair of the London Clinical Commissioning Council, on behalf of London CCGs.

The agreement set a distinctive course for London, different in style from the Manchester model, with health and wellbeing at the centre, reflecting London’s geography and political shape.

  • The Healthy London Partnership (HLP) programmes support the over-arching aim to ensure visible health gains for Londoners.
  • Fourteen principles will underpin the agreement, reflecting the scale and complexity of services in London, the profile and health needs of Londoners, and the geography and governance structures that lead the city.
  • Local devolution will be driven by integration across health and social care, and across organisational boundaries, with maximum pooling of finances compatible with the local context.

To test the principles and promote further collaboration, locally themed devolution pilots are already underway.

  • Haringey are introducing planning and licensing powers to develop new approaches to public health
  • Barking, Dagenham, Havering and Redbridge – have an Accountable Care Organisation
  • In north central London, Barnet, Camden, Enfield, Haringey and Islington are collaborating on estates and assets
  • Lewisham has been working on integrating physical and mental health alongside social care
  • Hackney is working towards fully integrated budgets in health and social care

The London Health and Care Devolution Programme Board will oversee the programme with the London Health board. Board members have established the London Estates Board LEB to provide a single forum for estate discussions in London. It brings together expertise from across London, and includes representatives from STPs, local areas and national partners, including NHS Property Services, Community Health Partnerships, HM Treasury, Department of Health and One Public Estate. The board will be supported by the London Estates Delivery Unit (LEDU) which is supporting local and STP areas to develop clear, affordable capital and estates plans.

The LEDU will provide access to expert resources and is working with local areas to develop an up-to-date asset register and list of prioritised sites, and broker discussions with national bodies. A wide range of other functions will be available to Local Estate Groups through ‘virtual’ partnering arrangements.