As the key organisations involved in health and social care services in Hackney, we are committed to supporting everyone in the borough to lead happier, healthier lives.
We have a shared vision of delivering an integrated, effective and financially sustainable system which covers the entire range of wellbeing - from public health initiatives for school children, timely and appropriate access to GPs and top quality hospital treatment, to excellent mental health services and supporting older people to live independently in their communities for as long as possible.
We already have a good track record of working together; we are one of the few areas in London delivering on performance targets and able to invest in new services. However, Hackney is a rapidly changing borough and there still exists a lot of health inequalities. We need to do more if we are to fully realise our ambitions, meet each one of the ten priorities of Better Health for London, and play a leading role in supporting the NHS’s Five Year Forward View.
To varying degrees, our organisations are experiencing significant funding pressures, which have placed our health and social care services under immense strain, and we know there are more to funding cuts to come. In that context, it's our responsibility to make sure the resources we do have are used in the most effective way for the residents we serve.
This is why we are aiming to become a successful local devolution pilot. We believe the additional powers and resources this would grant us offers the best chance to further develop integrated health and social care services to make the most of every pound we get, and help realise on our shared vision for Hackney.
We want to accelerate our work to improve health outcomes in the borough – particularly in regards achieving parity between mental and physical health services - and we will work with clinicians, practitioners, service users and patients to identify the priorities for accelerated improvement.
Key to this will be exploring the potential and benefits of a single membership delivery organisation taking responsibility for Hackney’s whole population, including testing how our combined financial resources and a capitated budget could transform services more effectively. We believe this approach will create incentives for prevention and early intervention, proactive primary care, better access to community services and the creation of safe and high quality alternatives to higher cost hospital-based or residential care. This new organisation would remain part of the NHS and social care system and accountable to the public.
No decisions have yet been made and we are still shaping plans, though a 16-month timeline has been sketched out, as detailed in our outline proposal. However, all partners are committed to providing a range of resources to support this proposition. We will also be seeking resources and expertise, in-kind or through transformation funding, from NHSE or through access to uncommitted CCG surpluses over the next 18-24 months, to help develop the detailed business case, implement the pilot and evaluate our progress, so that the experiences in Hackney can support transformation across London and beyond.
Throughout this process we will continue to fully involve the public, service users and patients, carers, the voluntary and community sector, and health and social care professionals in designing the model and the services within it. All partners will share their learning and experiences with each other. Hackney Health and Wellbeing Board will continue to provide the local leadership and overall governance for these developments.
As one of the London devolution pilots, the partners support the intent and purpose of the London Health and Care Collaboration Agreement. We recognise that the pilot opportunity is part of a larger effort at testing how devolution might work across London or sub-regionally, and will collaborate fully with the North East London sub-region. We will engage with London’s leadership, the London Programme Support Team, other London pilots and national partners to ensure there is coherence between our plans and other London reforms.
We anticipate working with UCL Partners to support the evaluation of the pilot. In addition, we will regularly feedback to and take guidance from national bodies such as the Local Government Association, NHS England, Public Health England, Health Education England, the Care Quality Commission, NHS Improvement (Monitor) and the Health Care Professions Council.
The signatories to this agreement are:
London Borough of Hackney
Cllr Jonathan McShane
Cabinet Member for Health, Social Care and Culture
Chair, Hackney Health and Wellbeing Board
City and Hackney Clinical Commissioning Group
Dr Clare Highton – Chair
Paul Haigh -Chief Officer
Homerton University Hospital Foundation Trust
Tracy Fletcher - Chief Executive
City and Hackney GP Confederation
Laura Sharpe - Chief Executive Officer
Paul Fleming - Chair
East London Foundation Trust
Dr Robert Dolan - Chief Executive
City & Hackney Local Pharmaceutical Committee
Raj Radia - Chair
City and Hackney Urgent Healthcare Social Enterprise
Victoria Holt - Clinical Director
Hackney Health and Social Care Forum
Alistair Wallace - Chair