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London Health and Care Devolution Memorandum of Understanding signed

The London Health and Care Devolution Memorandum of Understanding (MoU) was signed last week by London, national partners and central government. We currently have some high-level details which we can share with you, we will share more specifics about what this means for London general practice as and when we get them.

Through the MoU, NHS England has committed to delegate or devolve some commissioning functions to within the London system, including primary care and some specialised commissioning. There will also be greater freedom to sell un-used NHS land inside London to invest across the health system.

Our hope is that the freedoms provided by the MoU will facilitate a more joined up approach to coordinating primary care, secondary care, local authorities, the Mayor’s Office, community services, charities, voluntary groups and everyone else who has a role to play in the health of Londoners. The ambition is to make sure people are accessing the right services in the right place and supported to get healthy and stay healthy.

The devolution deal is structured around a number of areas:

Integration

The MoU provides opportunities to for closer working between local authorities, NHS providers and commissioners to guide the commissioning of services that best meet the needs of local communities. To support this, London’s share of transformation funding will be delegated from April 2018, so that investment decisions can be taken in London for the greatest benefit for Londoners.

A health and care systems working group will support these emerging partnerships and provide a single place in London for accessing, sharing and spreading learning across all the different bodies who can influence people’s health.

Workforce

A London Workforce Board has been recently established, bringing together health and care partners and ensuring a collaborative strategic approach to London-wide issues, particularly those which cross health and social care. The MoU also enables London to collectively work with central government to explore London weighting, although precise details of this are pending.

Estates

The NHS owns £11bn worth of land in London and the MOU makes it easier for it to sell of land it is not using and invest the money in estates, with a particular emphasis on primary and community care. A London Estates Board (LEB)  and London Estates Delivery Unit (LEDU) will be established to support estates projects. The LEB is intended to provide a single forum for estate discussions in London, bringing together expertise from across London alongside national partners.

Prevention

London will work with the Department for Education with the aim of ensuring revenue from the soft drinks industry levy is able to achieve the best value for young Londoners.

London partners will also explore options to further restrict the advertising and marketing of unhealthy food and drink in specific locations based on health harm. London partners will also be taking firmer action within existing powers and will support city-level action to address the wider determinants of health. There will also be a programme of support designed to help people suffering from mental illness to remain in work, with the hope that doing so will aid their recovery.

Governance and delivery

The London Health and Care Strategic Partnership Board (SPB) will take on a more strategic role and ultimately evolve to become a decision-making forum, able to oversee devolution in London. The SPB will report into the London Health Board (LHB), which is chaired by the Mayor of London and provides political oversight. Healthy London Partnership (HLP) will change to support health and care transformation more broadly through wider and more formal collaborations with the Greater London Authority, London Councils, Public Health England and wider partners.

Last updated : 20 Dec 2017

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