We are here to provide oversight of the healthcare system so that we:

• Help our residents and communities live healthier lives
• Ensure access to more consistently high quality healthcare services across North West London
• Tackle inequalities in how people access and experience healthcare and the outcomes they get from our services
• Work with local people, employers and partner organisations to strengthen our communities and make best use of our resources.

 We work with local residents, local NHS bodies, local councils, the voluntary and community sector and Healthwatch to develop the health and care strategy for our area.

We work as part of the North West London Integrated Care System (ICS) with local authorities and the organisations that provide NHS care, such as hospitals and GPs, which we have oversight of.

The ICS includes eight London boroughs – Brent, Ealing, Hammersmith and Fulham, Harrow, Hillingdon, Hounslow, Kensington and Chelsea and Westminster – all of these local authority members are part of our Integrated Care Partnership (ICP). It also includes seven NHS Trusts, who provide healthcare to our residents:

• Central and North West London NHS Foundation Trust
• Central London Community Healthcare NHS Trust
• Chelsea and Westminster |NH|S Foundation Trust
• The Hillingdon Hospitals NHS Foundation Trust
• Imperial College Healthcare Trust
• London North West University Healthcare NHS Trust
• West London NHS Trust

The ICP also includes two providers of specialist care – Royal Brompton and Harefield Hospitals and The Royal Marsden as well as the London Ambulance Service.

In each borough, we work in partnership with the local authority and the hospitals, mental health Trusts, GPs, pharmacists, dentists and community services that provide NHS services. As Westminster and Kensington and Chelsea work jointly, this means we have seven ‘borough-based partnerships’.

The 2001 census reports a population of 2.1m across our eight boroughs. An additional 400,000 patients are registered with a virtual service called GP At Hand, meaning we are responsible for an estimated 1.5 million patients.

There are 15 areas in which we have dedicated programmes of work:

• Local Care
• Primary Care
• Elective Care
• Diagnostics
• Urgent & Emergency Care (UEC)
• Mental Health Learning Disability and Autism (MHLDA)
• Maternity
• Children and Young People (CYP)
• Cancer
• Tackling Health Inequalities
• Finance
• Estates
• Digital and Data
• Workforce
• Communications and Involvement

Our draft five-year Joint Forward Plan (JFP) has set nine priorities to improve healthcare in North West London:

• Reduce inequalities and improve health outcomes
• Improve children and young people’s mental health
• Establish integrated neighbourhood teams with general practice at their heart
• Improve mental health services in the community and for people in crisis
• Embed access to a consistent, high quality set of community services
• Optimise ease of movement for patients across the system throughout their care
• Transform maternity care
• Increase cancer detection rates and deliver faster access to treatment
• Transform the way planned care works.

The draft JFP is due to be discussed at each of our seven Health and Wellbeing Boards, which are joint boards made of local authorities and NHS leaders in each borough.

You can read about the comprehensive and wide-ranging approach we take to working with our residents and communities, which you can read about in the ‘Get involved’ section of our website.

In autumn 2023, North West London opened a state-of-the-art, purpose built centre of excellence for routine bone and joint surgery at Central Middlesex Hospital.

The Elective Orthopaedic Centre (EOC) does bone and joint surgery only. It is completely separate from emergency care services, so waiting times are shorter and surgery is less likely to be cancelled. Because bone joint surgery is all the EOC does, they are well practiced and experts in their field, meaning patient care will consistently meet best standards and provide high quality surgery, while also being more efficient and good value for money. 

The EOC opened 3 theatres in December 2023 and 5 theatres in April 2024. Its achievements so far include:

• 100% patient satisfaction
• More efficient treatment with patients able to go home sooner - an average length of stay of 2.8 days in the first 10 weeks of operation
• Financial savings through increased productivity of £545,000 in 2023/24

Our Community Paediatrics Service was struggling to cope with increased referrals and had received complaints from parents that children had to wait too long following their first appointment for assessment and diagnosis of autism.

The multi-disciplinary team identified and tested changes to the way we work to reduce waiting times.

This led to:

• A reduction in time from assessment to diagnosis for children under 11 from an average of 25 weeks to three weeks.
• Testing a new way of working with children over 11 years, which reduced time from referral to diagnosis from an average of 82 weeks to an average of 48 weeks.
• Improved staff morale, despite rising workload and ongoing challenges, with a renewed culture of improvement and learning across the department.

Central North West London NHS foundation trust (CNWL)’s community services in Goodall division are an ‘early implementer’ site for the national wound care strategy.

CNWL focused on a more consistent approach to supporting patients through their care, raising awareness across the system to identify and support wound care earlier.

This led to:

• Wounds being healed quicker. Healing rates at 24 weeks have improved from 14% from April -June 2023 to 57% in December for venous leg ulcers
• Fewer wounds recurring, which in turn reduced pressures on a range of services that include district nursing, complex wound care, GPs and acute hospitals.
• Better patient experience of services.

Our children and young people’s team are working to reduce the number of asthma hospital admissions for black and Asian children and young people in North West London. Initial analysis showed that inpatient admission rates for this group were more than double the rate for white children.

We commissioned local charity Young Brent Voice (YBF) to research the experiences, knowledge and feelings of young people with asthma and their families. YBF supported a group of youth peer researchers to talk to young people across Brent, Ealing, Kensington and Chelsea and fed the insights into action planning for this initiative, which is now showing promising reductions in admission rates.  

Harrow has London's highest prevalence of coronary heart disease (2.7% compared to London 1.9%). It is estimated that there are over 19,000 people in the borough with undetected high blood pressure, accounting for 6.7% of the whole registered adult population in May 2023.  

 Using an innovative machine learning model, the project team identified 19,030 residents in Harrow at high risk (over 60% chance) of having undetected hypertension.  

 The combination of data-driven geographical targeting, with community insights as to particular communal ‘hot spots’, supported the team in achieving a high rate of detection (one in five) where residents being screened were found to have a blood pressure reading outside of the normal range. Over 680 participants were screened and results were fed back to GP practices in Harrow for further action.  

Learnings from this project were a key contributor to the creation of an NHS North West London toolkit, for supporting professional colleagues across the system in leading community outreach campaigns focusing on undiagnosed hypertension. The creation of the toolkit was led by NHS North West London’s engagement team, and was co-designed by partners across each of our eight boroughs.  

The toolkit has been launched and wallet-sized blood pressure reading cards will be distributed to borough teams, to support in ensuring readings are easily shared back to practice. 

A previous programme of work in 2018/19 to agree a new model of care for adult community-based specialist palliative care services had been widely criticised by stakeholders including residents and local councillors in the most affected areas. We knew that this time we needed take a different approach and since this point our work has been underpinned by continuous and extensive public engagement. 

However, as much as the engagement approach, what has been important is the ‘tone’, which has been: 

• Humble – with a clear stance that we don’t have all of the answers 
• Honest – with us stating what is not deliverable and cannot be taken forward, being open about potential trade-offs, as well as being clear that there may be outcomes that not everyone will like   
• Transparent – with all minutes and programme documents published online 
• Receptive – with us considering and accepting new ideas, such as the establishment of a task and finish group focused on Pembridge to listen to and explore residents ideas on the IPU 

We began the new process of involvement in November 2021 with the publication of an issues paper that was designed to facilitate discussions between local residents, families and carers, clinicians and stakeholders on what high quality, safe, equitable care and excellent patient experience looks like. This acted as our case for change and a set of ambitions we could check any developments against. 

Involvement included: events and webinars for boroughs and across NW London; briefings at local borough, scrutiny and stakeholder meetings; 1-2-1 interviews and the development of case studies with local residents and representatives of the voluntary, community and faith sectors; linking in with local and national experts to inform literature reviews on specific issues faced by specific patient groups; and online surveys for residents and health and social care professionals. An engagement outcome report was produced summarising what we had heard. 

All of the feedback received then informed the development of the model of care by a working group – with equal professional and resident membership who worked through; definitions, evidence and specifications. This work extended over a twelve-month period (and over thirty meetings), allowing us to fulfil our commitment to respond to all issues raised and seek resolution. It was also striking how resident members felt their views had changed through their involvement and many professional members reflected how being part of the process had changed how they communicated with patients.  

Public engagement continued following the publication of the proposed model of care (August 2023) and options for implementation and shortlisting (late 2023) with further public meetings for NW London and individual boroughs. These are key factors in informing a revised model of care, the PCBC and the formal consultation process. 

We have worked with residents, service users and carers across North West London in developing our mental health strategy. This has included events in all eight North West London boroughs asking people what mattered to them about mental health services.

Part of the discussion has revolved around the balance between community-based services and inpatient beds, as the way mental healthcare is delivered has changed both nationally and locally in recent years. We recognise the need to ensure beds for those who need them and that proactive, community-based services can prevent inpatient admissions in many cases.

We expect to publish our draft mental health strategy in the summer of 2025. 

We ran two public consultations during 2023/24, discussing proposals for an elective orthopaedic centre in North West London and proposed changes to acute mental health services in Westminster and Kensington and Chelsea. In both consultations, NHS North West London worked in partnership with NHS trust colleagues to reach as many of our residents and communities as possible. The mental health consultation was expanded to allow more time for residents, service users and carers to respond.

Following a broadly positive response, the elective orthopaedic centre was opened in December 2023 at Central Middlesex Hospital and is already seeing patients and reducing waiting times for key operations such as hip and knee replacements. 

The outcome of the consultation on acute mental health services will be decided in 2025, after we have considered feedback from the consultation.