Central London CCG covers the majority of Westminster. For the Queen’s Park and Paddington area of Westminster please visit the Kensington & Chelsea services page as these are covered by West London CCG.

Westminster is a densely populated and vibrant borough at the heart of London, with a daytime population three times the size of the resident population.

  • Imperial College Healthcare NHS Trust and Chelsea & Westminster NHS Foundation Trust are the main providers of acute and specialist care. Patients also use hospitals outside North West London when convenient.
  • Central London Community Healthcare NHS Trust (CLCH) provides community nursing and therapies.
  • Central and North West London NHS Foundation Trust provides mental health services.

Central London CCG annual report.

The chair of Central London CCG:

Dr Neville Purssell

Population demographics

  • 230,000*
  • The age profile in Westminster is common to other inner city areas in that it has a very large working age population and smaller proportions of children (in particular, it has the smallest in London).
  • The proportion of the total population aged 65+ is similar to London, but not as large as England.
  • Four in 10 (38%) of the population are from black, Asian and minority ethnic (BAME) groups.
  • Westminster has a smaller black population and Asian population than the London average, but the largest proportion nationally from the ‘Arab’ group (e.g. Middle East & North Africa) and the 14th highest from ‘Mixed’ groups.

*based on 2013 ONS figures

Health challenges

  • The principal cause of premature (<75 years of age) death in Westminster is cancer, followed by cardiovascular disease (which includes heart disease and stroke). A significant number of people also die from Chronic Obstructive Pulmonary Disease (COPD).
  • Children in Westminster attend A&E and other urgent care much more frequently than is typical for London or England.
  • In 2012, Westminster had the seventh highest reported acute Sexually Transmitted Infections (STI) rate in England.
  • Westminster also has one of the highest rates of homelessness and rough sleeping in the country. This vulnerable population increases the prevalence of drug and alcohol-related conditions, as well significantly increasing the need for mental health services.

Service improvements

Integrated care

  • Triborough Integrated Community Independence Service (CIS). This new service started in April 2015 and is provided by health and social care services working together, seven days a week, to provide rapid response services to help patients avoid hospital admissions, in-reach services to bring people home sooner from hospital admissions, rehabilitation and re-ablement services to help people return to independent living as soon as possible. 
  • Central London’s Village Working project brings together a multi-disciplinary team (MDT) that includes community nursing, mental health services, voluntary services and social services to look after patients at very local levels. Service investments in this year included introducing environmental housing officers and pharmacists to the MDT. This model is the fore-runner to our emerging model for Whole System Integrated Care.
  • Joint Primary Care / Paediatrician hubs: integrated clinics, bringing together primary and secondary care for children, have been set up in primary care hubs. These provide an alternative to going to hospital for children’s health services, in locations that are closer to people’s homes. There are now four hubs and, so far, 52 patients have benefitted.

Community and GP services

  • Cardiology & Respiratory: the contract for a new, integrated cardiology and respiratory community service in was awarded in February 2015, and the new service started in April 2015.
  • Musculoskeletal & Ophthalmology: musculoskeletal and ophthalmology services have been procured and are due to mobilise before the end of 2015.
  • Gynaecology & urology: a joint gynaecology/uro-gynaecology service and a urology service have been procured and are due to mobilise before the end of 2015.
  • Expert patient programme: investment continues in the expansion of the programme which empowers patients by providing training in areas such as coping with depression and planning for the future.
  • Urgent Care Centres: a national review of the urgent care system and the role of Urgent Care Centres within it is underway. We will make changes to ensure that primary care services and urgent care centres are used appropriately to peoples’ needs and cost-effectively.
  • Prime Ministers Challenge Fund (PMCF): 35 practices are taking part in PMCF, which supports practices in providing patients with more convenient access to primary care through investment in key services.
  • Extended access to GPs: four practices provide walk-in clinics with same-day GP and nurse appointments on weekends for eight hours. Two practices offer appointments from 8am-4pm, and two from 10am-6pm.
  • Efficient appointments: 19 practices provide phone consultations, 17 practices offer online appointment booking and 21 practices offer longer appointments where needed. Building on the learning from the Skype consultation pilot in 2014, more practices will be offering online access.
  • Improved buildings: the CCG is investing in the buildings and space needed to bring more services out of hospital in to locations that are closer to patients’ homes.

Mental health and wellbeing

  • The Primary Care Plus Mental Health service is now operational across Central London, supporting patients with non-urgent mental health conditions to access the support services they need in community settings as an alternative to secondary care.
  • Improving Access to Psychological Therapies (IAPT): Central London CCG is working to achieve its 15% access target for patients in need of psychological therapies. Significant investment has been made in secondary care, primary care, and the voluntary sector to ensure that people with mild anxiety and depression can access services to keep them well.
  • North West London was the second area nationally to have its action plan approved for the ground-breaking Mental Health Crisis Care Concordat, ensuring better, joined up, care for people experiencing mental health crisis.
  • Central London is contributing to the development of a mental health and wellbeing strategy across North West London. This will involve partnership working across health and social care and other partners.
  • Since April 2015 we have had a Child and Adolescent Mental Health Services (CAMHS) professional available 24 hours to respond to crisis.

Our future plans

Whilst we have made significant improvements, there is still more we want to do to improve care in Westminster.

Integrated care

  • Increase investment in neuro-rehabilitation community support and bed-based intermediate care in the community to support recovery and return to independence.
  • Extend Personal Health Budgets to adults with long-term conditions to give people more choice and control over how they are supported.
  • Working with public health team to develop supportive and resilient neighbourhoods and communities across the tri-borough, reducing demand for health and social care services and improving individual outcomes (e.g. Community Champions).

Mental health and wellbeing

  • Increasing investment to increase the size and scope of the Primary Care Plus mental health service, to enable more people to receive mental health services in primary care, complemented by new services being provided by GPs.
  • Continued support for Improving Access to Psychological Therapies (IAPT): As outlined above, Central London CCG is working to achieve its 15% access target for patients in need of psychological therapies. This is an essential part of increasing access to therapies like Cognitive Behavioural Therapy (CBT) so that more people can stay well and return to employment.
  • Working with our local mental health trust, we will be improving access to urgent mental health services through changing the pathway and interfaces between services. This is likely to include implementing a single point of access and reconfiguring teams to deliver a service which is able to respond to the needs to patients in crisis. 

Community and GP services

  • Improving primary care and access to it – the CCG will make primary care more convenient and easier to access for patients by extending the opening hours of a number of local GP practices to twelve hours per day on weekdays, and twelve hours at weekends. 
  • Our review of the urgent care system is indicating that urgent care services need to be more closely aligned to primary care services. We will make changes to ensure that primary care services, urgent care centres are used appropriately to peoples’ needs and cost-effectively.
  • Improved buildings: Central London is investing in the primary care estate needed to deliver more services in an out of hospital setting. Two practices will receive a share of £45,000 to improve their buildings.  In addition, we will be developing three new out-of-hospital hubs to deliver further services in the community
  • Increase the reach of outpatient and elective services in the community: our new community services will provide approximately 20,000 appointments in the community instead of hospital.
  • Community transport services: we are reviewing, with input from patients, the benefits of investing in improving community transport services, especially for those with mobility or social isolation issues.
  • Additional investment in homelessness services: the CCG is currently working on a number of initiatives related to improving our homeless population’s experience of healthcare, keeping them well and reducing demand on healthcare services. This will include continuing to invest in Hepatitis C clinics, improving care planning and GP and nursing input into existing services.
  • Integrated Home Care services: the CCG and the local council are working together to specify a new home care service model and pathway, with a focus on regaining independence following a stay in hospital.
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