Our Healthier South East London Partnership Update March 2019 Edition

Our updates provide an overview of the work of Our Healthier South East London, the Sustainability and Transformation Partnership for south east London, over the past couple of months. They are designed for sharing with boards, governing bodies and other key partners and stakeholders.  


At a glance  

  • Launched on 26 February 2019, residents in south east London can now access a new enhanced NHS 111 Integrated Urgent Care (IUC) service. Available 24 hours a day, the service will provide a new Clinical Assessment Service made up of GPs, pharmacists and nurses who will work together to recommend a clinically appropriate course of action for south east London residents who call 111. Staff will also be able to book appointments for patients in some settings, such as urgent care centres. The Clinical Assessment Service will also provide advice to a range of health and care professionals working in the community, such as nursing home staff, to help care for patients outside of hospital settings.
  • In February the NHS across the whole of south east London commissioned XenZone’sonline counselling service, Kooth, giving local children and young people aged 11-19 access to free, anonymous mental health and emotional well-being support. 


Update from programme groups   


In January, we delivered a very successful new roles workshop with a focus on Care Navigators and Medical Assistants. The session provided real examples of how non-clinical roles can improve the patient journey and support clinicians with administration and free up clinical time. National recognition has resulted in an offer of additional Health Education England funding. This resource will be used to accelerate testing of a new, on-line and module-based approach to Care Navigator training intended to offer more flexibility in training and ultimately support expansion of our primary care teams. 

Our February workshop profiled the Physician Associates (PA) profession. This is a relatively new and intensively trained clinician offering additional capacity and skill to the multi-professional general practice team. Our event gave SEL partners the chance to hear from the university trainers and experienced practising PAs how this role safely contributes to patient care and reduces pressure in the GP team. The event also signposted those interested in offering placements to PA students and recruiting a PA, to supportive information and resources.

Collaborative work across the system continues in relation to the nursing workforce. We are finalising details of new projects to grow and develop our nurse workforce which will be implemented soon. These projects include mapping existing nursing placements to help identify where more training can be supported; piloting a new approach to managing placements to plan for expansion in the number of nurses trained; further training in key skills for existing staff and; support for current healthcare support workers interested in becoming a nurse associate to achieve the required standards to join the training.


Urgent and emergency care  

To better support our workforce, we have successfully bid for funding from HEE to develop a programme to support the health and wellbeing of staff working in urgent and emergency care settings. The programme will help staff to build skills to increase personal resilience and to act as wellbeing champions within their organisations. Three members of nursing staff will be selected from each of our five emergency departments, forming a network of 15 frontline leaders across SE London. The training will be delivered by the mental health service provider South London and Maudsley NHS Foundation Trust.



The South East London Maternity Better Births delivery plan was created after the National Maternity Review in 2016 and focuses on supporting maternity services in several areas that will improve safety and the woman and family’s experience.   

Priorities for south east London over the coming months include:  

  • In partnership with Trust digital leads we are developing personalised care plans (PCP) for all women. The aim is to empower women to take control their pregnancy and birth experience. Women will own their PCP and through discussions with their Health Care Professional discuss what is important to them and their family and personalise their experience.
  • We will be developing a south east London maternity choice offer for women and their families. The choice offer is a directory of services which details the choices for pregnancy, birth and the postnatal period within our community. We will enhance what is currently available on the OHSEL and Trust websites to include the latest NHS England aids and information.


Mental health  

The SIM (Serenity Integration Monitoring) project is currently being piloted in Greenwich and Southwark. The project focusses on a small number of service users who have complex mental health conditions to ensure they receive support from numerous emergency teams on a regular basis including the police and ambulance call out staff. The project employs a dedicated police officer, who has received training in mental health, to work closely with clinicians to provide intense mentoring and support for the service users involved in the pilot. The result has seen a significant reduction in use of Police intervention (section 136) and presentation at A&E for these individuals. The SIM project is now being rolled out across the remaining south east London boroughs with Bexley, Bromley & Lewisham expected to go live in March and Lambeth later this spring. The project is managed by the SIM Strategic Delivery Board.



With the publication of the new long-term plan for the NHS we are taking the opportunity to refresh out digital strategy to ensure the programme meets National and Regional requirements plus our own local improvement programme. Currently we are working on the further development of the new NHS App which will create a “digital front door” for members of our communities. Lambeth CCG will be taking the lead on the implementation followed closely by the other CCGs. Additionally, members of the digital team are working closely with other STP colleagues on the development of a London wide “Local Health & Care Record” as a part of One London. One London’s system will provide access for a shared care record across London and anonymised data for Population Health/data analytics purposes. We have now completed the Primary Care digitisation project; scanning historical patient records at over 30 GP practices which has created potential for additional clinical areas.



We have secured funding to support bowel, breast and cervical cancer screening programmes. Methods to increase uptake include personalised phone call reminders for people who do not response to their screening invitations and training for staff at GP surgeries to promote screening and help manage those who do not respond. The Living With and Beyond Cancer team has developed a policy to standardise breast cancer follow-up care to address the unique needs of people living with a cancer diagnosis and help improve outcomes for patients. In practice, this means more in-depth consultations following treatment with needs and care plans; treatment summaries; signs and symptoms to look out for and psychological support.   

 South East London and Kent and Medway Cancer Alliances held a joint workshop in February to improve the experience for patients transferring between the two regions for cancer treatment. Focusing on hepatobiliary (concerning the liver, gallbladder or bile tract), and oesophageal gastric cancer pathways, the teams worked to address complications in the referral and treatment process and agreed actions to deliver over the next few months. The Alliances will reconvene in May to review progress and more joint workshops are planned for April and early summer.  


Community based care

The NHS Long Term Plan identifies the development of “primary care networks” as essential building blocks of every integrated care system. Primary care networks are described as groups of practices coming together locally in partnership with community services, social care and other providers of health and care services around the needs of a geographically coherent population or “local neighbourhood”. This development is being incentivised through £4.5bn of national investment and changes in the General practice contract framework, to support all general practices come together to form primary care networks by July 2019.

We have a good history of partnership work across South East London and have invested in local general practice to support them to come together with other local health and care providers to test and develop neighbourhood delivery models. The first step is to agree the list of primary care networks by May/July and to appoint clinical directors to networks.