London Health Forum

LHF Health Indicators Report: Quarter One 2011-12

Our quarterly Health Indicators report monitors four health outcomes in London to keep track of how health services in the capital are performing. This, our second report, highlights growing waiting times in the capital, and continuing inequality between the lengths of waits in different parts of the city. Further, London's continuing underperformance in immunisation rates is also examined in comparison to the rest of England. This underperformance hides the variation within London, with different boroughs scoring amongst the best and the worst vaccination rates in the country.

Further to the London Health Forum's February 2009 report on London's funding formula, this paper looks at PCT resource allocations in London. In a new context of reduced resources and the impending transition of primary commissioning duties away from PCTs, the Forum examines the potential funding risks that different parts of London might face in the coming years.

London's ageing population and its impact on visually impaired service users

Greater awareness of eye health and improvements in Joint Strategic Needs Assessment for those with sight loss are essential if London is to cope with the impact of an ageing population.

London has the highest tuberculosis rate of any capital city in Western Europe. This article raises concerns regarding the organisation of TB services in the capital and the importance of a holistic approach to tackling London's TB crisis.

In response to the government's White Paper on the future of public health in England, Terrence Higgins Trust wrote this article for the London Health Forum which explores how changes to the organisation and funding of public health may impact upon HIV services. In the year ahead the London Health Forum will be publishing regular articles looking at particular issues facing London.

The London Health Forum has responded to the government’s White Paper on the future of the NHS. The Forum welcomes aspects of the proposals such as the greater involvement of local authorities in public health. It does, however, express concerns in a number of areas such as the ability of GP-led commissioning to meet the needs of hard-to-reach groups, the consequent importance of a London regional office of the NHS Commissioning Board, the need to ensure that resource allocation recognises the particular demographic challenges facing London and the importance of protecting sources of data about health in London during the transition to new arrangements.

The London Health Forum has published an update of its report on debt and health, originally published in September 2009. The new publication finds that, despite better than expected economic conditions, the number of Londoners seeking debt advice rose by some 25 per cent between 2008 and 2009. As public spending cuts begin to bite, this suggests that the need for timely advice will continue to grow if the negative consequences of debt for health are to be ameliorated, with the NHS playing a leading role.

The report is accompanied by slides offering a wealth of information about various debt indicators broken down by PCT/borough.

The London Health Forum has welcomed publication of the Mayor’s Health Inequalities Strategy and its emphasis on partnership working. It is, however, keen to see the Mayor champion some core issues to invigorate the process of implementation.

As part of its project seeking to reduce the impact of the recession on mental health, the London Health Forum is publishing a leaflet setting out information and advice enabling people to get debt advice sooner. The leaflet is being widely distributed, particularly through the NHS in London. A copy is attached.

The Care Quality Commission has recently published its annual NHS health check. The London Health Forum has looked at the results for London in a bit more detail and sets out its comments in the attached article.

The London Health Forum has published a major new report on debt and health in the capital. The report looks at the growth in personal debt, the link between debt and ill-health and the benefits of debt advice before going on to make a series of recommendations, including:

· NHS steps to communicate to healthcare professionals the importance of debt advice in preventing ill health;

· Greater use of NHS channels to inform people about the various providers of free debt advice, including online advice to relieve the burden on telephone and face-to-face providers;

· Continued funding for all types of debt advice in London during what promises to be a protracted period of high unemployment.

Our latest batch of reports covering healthcare and outcomes in five boroughs is now available. Do get in touch if you would like PDF copies. The reports cover Harrow, Lambeth, Redbridge, Sutton and Merton and Wandsworth. We also have reports from last year covering Bexley, Camden, Hammersmith and Fulham, Newham and Westminster, which are also available on request.

A year after the London elections, the Forum has revisited its manifesto and the extent to which developments have matched up to the priorities for healthcare in the capital. Useful progress has been made in a number of areas with continued delay in publication of the Mayor's health inequalities strategy the major omission.

London continues to trail the rest of the country in relation to childhood immunisation rates. The discredited Wakefield study linking the MMR vaccine with autism had a passing impact but the roots of London's problems go deeper and need to be addressed urgently if serious outbreaks of disease, notably measles, are to be avoided.

After a protracted review of the way in which resources are allocated within the NHS, the Secretary of State announced funding levels for the next two years just before Christmas. Although London's position is protected in the short term, the new formula means that all Primary Care Trusts except Redditch are now theoretically overfunded. This reflects a shift in emphasis from health inequalities to the age of populations and could cause difficulties for London in the future.

The London Health Forum has published a report and recommendations on how London's statutory sector can get the best from voluntary sector providers while also recognising the contribution of the private sector. The report shows that the commissioning of services by the NHS and others is still falling short of best practice and therefore failing to get the most from the voluntary sector. For example, only 8.7 per cent of London commissioners have mapped local providers in the last year and nearly half do not know whether providers have been mapped at all. Similarly, more commissioners report utilising an average contract length of one year compared to use of three years as recommended by HM Treasury. Shortcomings on both sides need to be remedied if services are to be optimised during the recession.

The London Health Forum has published new research on the major health challenges facing Inner and Outer London, showing how the different parts of the capital have distinctive lifestyle patterns, necessitating a targeted approach to improving health. Inner London has higher levels of adults who smoke and binge drink but its population tends to eat more healthily and is more physically active. Meanwhile, Obesity is a bigger problem in outer London, although inner London has higher rates of early death from heart disease and cancer. These findings suggest that the NHS in London and its partners may need to utilise differing strategies to improve public health, based on the characteristics of the communities being served.

The London Health Forum has published a manifesto for the Mayoral and London Assembly elections in May 2008. The manifesto sets out seven key pledges aimed to improve the health of Londoners, covering commissioning, preventative services, partnership working and other areas. With an expanding role for the Greater London Authority in health, this is an opportunity to put these issues at the top of the political agenda. The Forum is asking all candidates to register their support for the manifesto.

The London Health Forum has written to health minister Ben Bradshaw MP to outline its view that London may not be getting a fair deal on the allocation of resources within the NHS. The Forum's recent report, World Class Health Services for a World City highlighted the particular health issues London faces; however, several London PCTs serving some of the most disadvantaged areas of the country have consistently received a level of funding below their target level. Making sure the funding formula reflects the capital's needs is a challenge especially because of the diversity of income and wealth, London's large transient population and the many people who work in the city but do not live there. Significant population growth in the east of the city will also need to be fully accounted for when a new funding formula is implemented in 2009/10. London's Borough councils have echoed the Forum's views about the risk of London losing out on resources. Population statistics released by the Office of National Statistics show London's population down 100,000 on previous projections, which does not correspond with Boroughs' own figures. One estimate shows Boroughs experiencing a loss of £130 million over three years because of this calculation. We urge the government to review this situation and ensure future health spending allocations accurately reflect the needs of Londoners.

March 2008

World class health services for a world city

The London Health Forum has formally been launched by Nicola Horlick, the inaugural chair of the Forum. Speaking to an audience of politicians, health service executives and patients' representatives, Nicola spoke about how to address the major health challenges facing London: "It is vital that the health service, local government and others develop strong partnerships with the voluntary and private sectors to reach out to people who need support to live healthier lives."

In conjunction with the launch, the London Health Forum has published its report, World Class Health Services for a World City: the Olympic challenge facing London , examining the demographic, spending and outcome issues facing the capital and setting out its initial priorities for action.

The London Health Forum has responded to the Healthcare for London proposals setting the principles for the reform of the NHS in London. The proposals are based on the Framework for Action report by Lord Darzi. In its response, the Forum has emphasised the need to increase the focus on partnership as a way to improve the health of Londoners, and argued that improving access to primary care should be seen as the key priority in the debate over the introduction of polyclinics.