The challenge

In the summer of 2021, we worked with the London Health and Care Partnership, which includes the Regional NHS England Team, London Councils, the GLA and Office for Health Improvement and Disparities, to understand integration in London’s health and care system.

The aim was to capture learning from the pandemic, as well as the prior history of integration in London, to develop practical recommendations and support to future joint working and improvements in health and wellbeing across the capital.

The approach

Our work started with a critical literature review covering the period both prior to the Covid-19 pandemic and subsequent research looking at the challenges and changes that occurred across London since March 2020. The project engaged extensively across London, including representatives from all five London Integrated Care Systems, NHS, local government, voluntary and community sector organisations, as well as patient and community representatives.

The final report, co-developed with and building on extensive input from across London, is structured into five key sets of recommendations – the Purpose of integration in London, establishing local Priorities, the primacy of Place, establishing shared Pounds, and developing collaboration amongst Providers – collectively known as the “5 Ps” framework.

Intrinsic to all of these is a sixth P, People, encompassing both professionals working in health and care in London and the communities they serve, recognising their vital role in changing how we work.

The framework provides a practical basis for taking forward better integrated, community and person-centred care across a population of 9 million people, with a commitment to putting tackling inequalities at the heart of everything we do. Endorsed by senior system leaders in November 2022, it now forms a basis for developing our integrated care systems and borough-based partnerships from 2022 onwards, in a way that is respectful of local differences but with shared values and shared learning at its heart.