Showing posts with label Sustainability and Transformation Plan. Show all posts
Showing posts with label Sustainability and Transformation Plan. Show all posts

Friday 12 January 2018

Babylon on-line triaging not coming to Brent

From the Health Service Journal LINK
 
Commissioners in London have ditched a planned pilot of Babylon Health’s primary care app after patients in a test “were typically most interested in using the app to speed up GP access, rather than [using] the symptom checker”.

Clinical commissioning groups in north west London were testing Babylon’s app as a tool for reducing GP attendance, by triaging patients online.

North West London Collaboration of CCGs confirmed it had “considered” piloting the Babylon app but it was dropped after tests with patients.

A spokeswoman told HSJ:
“The CCGs considered the merits of this app as a tool to help manage demand on GPs – particularly through the symptom-checker feature.

“We worked closely with patients to find out what demand there was for the app. We found that patients were typically most interested in using the app to speed up GP access, rather than the symptom checker.”
A Babylon spokesman said:
 “Discussions were held after Babylon was selected in a competitive procurement exercise as the best technology to trial in GP practices across North West London. Subsequently a decision was taken not to fund the pilot.”
The CCG collaboration comprises Brent, Central London, Ealing, Hammersmith and Fulham, Harrow, Hillingdon, Hounslow and West London.
 
A CCG collaboration spokeswoman also said:
 “The information gathered from talking to patients was successful in informing the ongoing work of the sector as we explore this area further.”
It comes after a board paper for the CCG collaboration, dated 25 October, said that in the test of the app patients “effectively manipulated the system in order to secure GP appointments”.

The collaboration has, since this piece was first published, stated that this board paper was incorrect, and amended it.

The new paper says:
 “The board was updated on the evaluation work undertaken to inform a decision of whether to initiate a pilot with Babylon to see if the technology could drive reductions in demand for GP appointments.

“Work over the summer with focus groups to gather insights around perceptions had raised a concern that patients who might use the app could mainly do so because they believed it would get them faster access to GP appointments.

“The focus groups had also commented that there is a risk of some people gaming the symptom checker to achieve a GP appointment.

“The insights gathered therefore revealed that the symptom checker in particular was unlikely to reduce demand on GP services. This reduced the intended benefit of the system significantly. Following questions and further discussion, the board agreed not to proceed to the pilot stage.”

Another board paper from the chief executive of the CWHHE CCG group, in North West London, also dated October, said the app was tested with a “small group of patients” – the test “spanning six patient focus groups and a wide demographic area” in September. The plan had been to move later to a wider pilot involving about 16 GP practices.

Babylon, along with several emerging competitors, is a private company that provides on demand video GP consultation and a chatbot style symptom checker from a smart phone app.

The Babylon app is available privately for a monthly fee but is increasingly also being offered free to NHS patients through their GPs.

Babylon, headed by Circle founder Ali Parsa, is also heavily involved in several national projects with NHS England that, if successful, could lead the company to playing a major role in delivering online NHS services.

Concerns about Babylon’s role in the NHS increased this month after the company launched GP at Hand, a collaboration with London GP practices that will make its video consultation freely available to any NHS patient that switches to participating practices.

GP at Hand has been accused, mostly by GPs, of “cherry picking” relatively healthy patients and excluding those with more complex health needs.

A week after the service was announced, the London local medical committees passed a motion calling for a halt to the deployment of online GP services in the NHS until there was more robust evidence they benefited patients.

The north west London testing was part of the CCGs’ aim to use online consultations to reduce GP demand, as outlined in the area’s sustainability and transformation plan.

The Babylon project was funded by Health Education England with much of the assessment work carried out by Imperial College Health Partners. These organisations will continue to research alternative digital tools for accessing GPs in north west London.

A collaboration spokeswoman said: “The information gathered from talking to patients was successful in informing the ongoing work of the sector as we explore this area further.”

An HEE spokeswoman said the organisation had worked on a pilot with the CCGs and ICHP looking at digital solutions to free up time for busy practices, as well as how staff could be trained to use new technology. She added: “There is ongoing evaluation of this work and HEE continues to work with the STP and the CCG in looking at transformation of the workforce.”

Babylon’s full statement to HSJ said:
 “The NW London CCGs’ collaboration board paper item ‘NW London Babylon Pilot: Emerging findings’ is factually incorrect and deeply misleading.

“No pilot was ever carried out, nor any agreement signed with Babylon for such a pilot. Discussions were held after Babylon was selected in a competitive procurement exercise as the best technology to trial in GP practices across North West London. Subsequently a decision was taken not to fund the pilot.”
Babylon said in a further statement to HSJ this week:
“We have no assurances that any meaningful and robust user tests were ever carried out, and Imperial College Health Partners were not involved in any such testing.”


Wednesday 14 December 2016

Bid for £513m for NW London CCGs to be submitted to implement STP


Just after the Kilburn Times LINK published a story about the potential impact of the Sustainability and Transformation Plan (STP) on Brent, the NHS Brent Clinical Commissioning Group held an extraordinary Governing Body meeting at lunchtime today. The Times story pointed to a difference in emphasis on the STP from Cllr Krupesh Hirani, lead member for community wellbeing who said he would sign up to the STP, and Carolyn Downs, Brent CEO who has led on the STP, who repeated the caveats made at Brent's October Cabinet meeting*. The STP got very little detailed mention at today's meeting.  Ealing and Hammersmith and Fulham boroughs have refused to sign the STP at present.

The chair said that in seeking £513m investment the area CCGs were following through the controversial Shaping a Healthier Future  (SaHF) and the Sustainability and Transformation Plan . The investment was necessary to deliver these plans and the meeting considered the Strategic Outline Case (Soc 1) for the investment. 

The majority of the funding (£304)  would go to acute hospitals, most of it to Ealing Hospital. £69m to improving GP practices, and £141m to out of hospital hubs.
 
The £304m hospital share would:
  • support Ealing's changes to become an excellent local hospital
  • expand A& E and provide more beds at West Middlesex Hospital
  • expand A & E and maternity at Hillingdon Hospital
  • provide more primary and community care services at Central Middlesex Hospital
  • provide more post-op recovery and critical care beds at Northwick Park Hospital and improve some existing buildings
The £69m GP practices share would:
  • make it easier for patients to physically get in and out of practices
  • make better waiting rooms and more consulting rooms across all 8 boroughs
The £141m allocated to Out of Hospital Hubs would:
  • modernise 11 existing community hubs
  • build 7 new ones
  • increase capacity and enable people who have multiple health and care needs to have those dealt with in one place 

The overall aim was better health care and preventing unnecessary hospitalisation.

At the public question time Robin Sharp speaking for Brent Patient Voice said:
I thank the Governing Body for making 30 minutes available for public comments or questions during this session. I am afraid that the rest of what I have to say will be more critical.
Sadly we are presented with yet another example of flawed procedure and a flawed case for change on the part of our NHS.

To begin with procedures, it is farcical that the Governing Body are set to approve a complex 250-page submission only 8 days after it was put into the public domain. Doctors on the Governing Body are very busy people with important clinical jobs. How can they have had time to read and understand these proposals?

It is also disgraceful that 7 out of the 8 NW London Healthwatches which make up the PPRG (Patient and Public Representative Group) for SaHF have offered quasi-endorsement for the document even though they admit that the public they are supposed to represent have not seen it.

We are told there will be public engagement in future, but is not this the wrong way round? Engagement should have been before the document goes to the Treasury.

Turning to the clinical case for change, it has been over 3 years since the “Better Care Closer to Home” strategy set out in SaHF was launched. It was supposed to be all in place by 2015. Where is the assessment to show that more care in the community has stopped people being admitted to hospital and reduced the need for acute beds?  It is certainly not in the NW London STP (Sustainability and Transformation Plan). “If Better Care Closer to Home” works why are our A&Es among the most challenged in England. Why are Referral to Treatment (RTT) times on a downward trend?

We were told in the slide presentation that 27 Hubs across NW London are at the heart of this Business Case and that St Charles off Ladbroke Grove is an example of a fully functioning “Hub”. Can we please see a paper giving details of how this is working? As a patient of a nearby Brent practice who uses the Urgent Care Centre at St Charles I have to say that the existence of a Hub is a well kept secret. No-one has told me or my Practice PPG about it.
Maurice Hoffman asked if only a limited amount of the monies claimed was available how would it be distributed?  He asked if  a 'local A & E' would meet London standards. He was told that the CCG had made it clear to the NHS that all the proposals were inter-connected and they were pitching for the full amount.  He was told that a Charing Cross A & E would not take 'blue light' case and NW London CCGs were looking at what services for the frail and elderly could be best placed there.  He was assured that 'until we have the capacity we will not change anything.'

As the presentation had mentioned voluntary organisations as providing services in the hubs, I asked how this would work when NHS England and NHS Estates were saying that market rents had to be paid. There was a momentary silence while the governing body members looked at each other and then Sarah Mansurali replied that they were looking at giving grants to voluntary sector organisations so they could afford the rent, offering sessional space or try to integrate voluntary organisations into new models of care.

The Governing Body noted the scope of the SOC and approved Part 1 for submission to NHSE and NHSI for approval and asked for the following points to be considered prior to approving subsequent related Outline Business cases (OBCs):
  • further public involvement is undertaken where appropriate
  • the OBCs continue to justify the capital requirement set out in SOC part 1
  • opportunities to accelerate the delivery of the benefits are explored
  • opportunities to further improve the income and expenditure position of proposals are explored
It is worth noting that this meeting took place during the day on a weekday so opportunities for the public to attend were clearly limited.  

*Cabinet Minutes October 24th 2016:

1.     Cabinet noted the STP submission for North West London. 

2.     Cabinet welcomed the principles adopted within the STP of prevention, out  of hospital care, dealing with the social care funding gap and the need to work across the public sector to maximise benefits from changes to the NHS and other public sector estate. 

3.     Cabinet noted that the STP will need formal sign off by the end of December and that between October and December the following issues need to be clarified both within the submission and through other NHS processes, in 
 order for the council to give full support for the plan:
a.     That the IMBC on which delivery area 5 is based is released, debated and understood; 

b.     That the flow of monies from acute to out of hospital settings are clarified; 

c.      That the specification for out of hospital settings, in particular social care, are clarified
based on an agreed model of out of hospital care; 

d.     That a full risk assessment for the plan and relevant mitigations are included.


Friday 9 December 2016

NW London STP: 'Change is needed - but not like this'

From Brent Patient Voice LINK

This was the theme elaborated by Dr Julia Simon, former NHS high-flyer, when she addressed a packed and lively BPV public meeting last Thursday 1st December at the Learie Constantine Centre, NW10.

BPV Chair, Robin Sharp, explained that big changes to the way in which GPs relate to their patients were hidden away in the recently published NW London NHS Sustainability and Transformation Plan (STP). Essentially the Plan was about cutting £1.4billion from local health and social care service over the 5 years up to 2021, including previously announced proposals to “reconfigure” hospitals and cut beds. What was new was the plan to turn GPs from being a “cottage industry” to the brave new world of “Accountable Care Partnerships”.

Dr Simon told us she was not a medical doctor but had been a philosopher before moving into the healthcare world. For several years up to last September she was a senior leader at NHS England, working on primary care and commissioning issues. She had left to be able to break out of some of the constraints that being at NHSE imposed, not least in relation to the speed at which the STPs were being imposed across the country and the realism of some of the claimed financial figures.

Striding around the room like a university lecturer, Dr Simon captivated her audience with the clarity and honesty of her presentation. She said that in the 90s the idea of a market had been introduced into the NHS to drive up standards. This involved creating a division between “commissioners”, who worked out what was needed and paid for it, and “providers” such as hospitals and GPs who delivered it. The trouble was that under the NHS healthcare was not a market because it could not be allowed to fail.

In 2012 Parliament enacted the Health and Social Care Act, the brainchild of Andrew Lansley, whose wife was a GP. This put local GPs into 209 local Clinical Commissioning Groups to be in charge of designing and paying for about two-thirds of the health care provided by hospitals and in the community. The downside was enormous fragmentation because NHSE became commissioners for specialist services and local authorities for public health. In addition local authorities remained responsible for adult social care, which was means-tested, whereas healthcare was free at the point of delivery.

This was the context into which the new chief of NHSE, Simon Stevens, launched his plan for the future in 2014, the “Five Year Forward View”. As well as accepting that the NHS could make £22billion “efficiency savings” by 2021, this plan called for integration between GPs, hospitals and adult social care. All parties, medical bodies and commentators signed up to it without apparent reservation.

Then in December 2015 the annual Planning Guidance from NHSE to the CCGs and hospital trusts announced that implementation of the Forward View was much too slow and current trust deficits were “unsustainable”. The CCGs and trusts were grouped into 44 areas (Footprints) across England and required, working with local authorities, to produce STPs by 30 June 2016 to eliminate deficits and implement “transformation” over a 5 year period.

Meanwhile various experiments in new forms of integrating services locally had been launched under the brand of “Vanguards”. As Dr Simon explained these are still in progress and there are no evaluations. “The jury is out on the Vanguards”, she said.

The Vanguards include integrated primary and acute care systems, as well as multi-speciality community providers. The first of these embraces Accountable Care Partnerships (ACPs). Dr Simon spelled out some of the features of ACPs. These envisage a fixed budget for each patient (capitated budget), an emphasis on self-care and prevention leading to fewer hospital admissions and merging the boundaries between commissioners and providers. New legislation might be needed and there were some perverse incentives in the present system.

To conclude Julia Simon said that, while she was convinced that new approaches to organising the NHS and delivering care were needed the STPs had been produced in semi-secrecy and much too fast. Moreover the savings being suggested were not really credible. She likened the situation to George Orwell’s “1984” where officials state in public numbers that in private they admit are impossible. However she saw some signs that the top of the NHS would soon announce a delay enabling more serious public consultation.

Julia was congratulated by an audience member on delivering the most informative address he had ever heard from an NHS person. There was general support for this sentiment.

Her presentation was followed up by some 40 minutes of questioning and passionate statements of concern, especially at the unacceptability of the STP for NW London. Noting that Ealing and Hammersmith and Fulham Councils had refused to sign up to the Plan, audience members wanted to know what more could be done to persuade elected councillors in Brent and other boroughs not to endorse it.

Robin Sharp

Chair Brent Patient Voice

Thursday 8 December 2016

Extraordinary Brent CCG meeting on Wednesday to further controversial health plans

There is an Extraordinary Meeting of the Governing Body of the Brent Clinical Commissioning Group at noon-1.30pm on Wednesday 14th December at the Boardroom Wembley Centre for  Health and Care.  The meeting is open to the public and 30 minutes has been allocated to questions from the public.

The meeting is about the business case for Shaping a Healthier Future and the CCG consider this essential for delivering  the controversial NW London Sustainability and Transformation Plan. Cllr Krupesh Hirani confirmed in the Brent and Kilburn Times today that Brent Council intends to sign the STP despite the fact that neighbouring Ealing and Hammersmith and Fulham councils have refused to do so.

As usual the documents are massive, jargon ridden and with enough acronyms to fill Wembley Stadium.

Anyone who manages to plough through them AND understand them deserves an honorary degree.

Those who think that the STP, though argued on the  basis of benefits to patients, is really a cover for cuts may be interested in the Strategic Outline Case for investment to eventually save money: 
For trusts under the ‘comparator’ scenario, where no commissioner QIPP is assumed to be delivered and with business-as-usual CIP delivery, all our provider trusts will be in financial deficit, with a combined deficit of £114m at 2024/25. However, if commissioner QIPP were delivered, trustsI&E would improve to a combined deficit of £18m as additional CIPs can be achieved (termed the ‘SaHF scenario before reconfiguration). The CCG QIPP delivery is dependent in part on the building of the hubs, which is why it is not included in the ‘comparator’. If we receive the capital funding we are requesting, the trusts’ financial projections demonstrate that all trusts will have a sustainable I&E surplus position of £27.6m at 2024/25, with the reconfiguration contributing a c£50m benefit (termed the ‘SaHF scenario after reconfiguration’). 

Currently the trusts are running in-year deficits which would require an estimated cash support of £1.1bn over the next 10 years (and continue thereafter), which would reduce to £0.5bn under the ‘SaHF scenario before reconfiguration’ (where additional CIPs are delivered, partly due to hub investment to enable QIPP delivery). Under the SOC part 1 option (‘SaHF scenario after reconfiguration’), the cash deficit support in the 10-year period would reduce further to £0.4bn and are eliminated post reconfiguration. 

If the capital investment were funded by loans, two of the trusts would have a below target Financial Sustainability Risk Rating (FSRR) and be unable to meet the loan repayments. As the loan funding scenario is unaffordable from a liquidity perspective, we have explored two further scenarios and have concluded that our preferred option is for Public Dividend Capital (PDC) funding, and an accelerated timeline. 

We have also demonstrated that the case is affordable under a range of scenarios by conducting sensitivity analyses.
This is the Brent Cabinet decision as recorded in the minutes of the October 24th Cabinet meeting:


1.     Cabinet noted the STP submission for North West London. 

2.     Cabinet welcomed the principles adopted within the STP of prevention, out  of hospital care, dealing with the social care funding gap and the need to work across the public sector to maximise benefits from changes to the NHS and other public sector estate. 

3.     Cabinet noted that the STP will need formal sign off by the end of December and that between October and December the following issues need to be clarified both within the submission and through other NHS processes, in 
 order for the council to give full support for the plan:
a.     That the IMBC on which delivery area 5 is based is released, debated and understood; 

b.     That the flow of monies from acute to out of hospital settings are clarified; 

c.      That the specification for out of hospital settings, in particular social care, are clarified
based on an agreed model of out of hospital care; 

d.     That a full risk assessment for the plan and relevant mitigations are included. 


Saturday 3 December 2016

Ealing and Hammersmith & Fulham Councils show Brent how to campaign on the STP

 It is just not possible for me to go to every vital meeting that I advertise on Wembley Matters so I am posting this account from the Hammersmith and Fulham website of their public meeting on the NW London Sustainability and Transformation Plan.

How about a similar meeting in Brent, Brent Council?


The decision by Hammersmith & Fulham and Ealing councils to refuse ‘secretive’ hospital closure plans was backed by hundreds at a packed town hall meeting this week.

Nearly 700 cheered and applauded the leaders of the councils as they explained why they have refused to sign up to the local NHS Sustainability and Transformation Plan (STP). Councils across the UK have been asked to endorse similar plans for each region of the NHS, before they are submitted to government for approval.

“The STP is a deeply cynical re-hash of the earlier flawed plans which now proposes to close Charing Cross Hospital in 2021,” said Cllr Stephen Cowan, Leader of Hammersmith & Fulham Council.

“There are no good arguments for demolishing Charing Cross or for selling off much of the land and replacing it with an urgent care clinic just 13 per cent the size of the hospital. That’s why this administration will continue its fierce defence of Charing Cross and the vital local NHS services people rely on.”

The meeting drew campaigners from across the region who have been fighting plans to close or downgrade services at five out of the nine hospitals in north west London.

Despite the published plans, an NHS spokesman has said: “We want to reassure our staff, patients, local residents and partners that Charing Cross is not closing and that there will be no reduction in the hospital’s A&E and wider services during the lifetime of the STP, which runs until April 2021.”
Anne Drinkell, of the Save our Hospitals campaign, said: “This is a cuts and closures programme. We’re not saying we want no change. But objectively there’s already not enough capacity in our local hospital so closing more services would be unsafe.”

Campaigners were united in condemning the tactics being used to force through drastic reductions in local health services secretively and without public consultation.

The NHS has pressured councils to approve STPs by linking it to the release of vital government cash needed to keep councils’ social care services from collapsing under ever-rising demand.

But Cllr Julian Bell, Leader of Ealing Council, said: “The NHS tried to bounce us into signing the STP. They tried to get us to agree to the STP on the basis of a two-page summary and they told us we didn’t need to see the full document. We insisted, but it didn’t arrive until they day before we were meant to sign it. And once we finally saw what was in it, we understood why. There was no way on earth I was going to sign up to those plans.”

Dr David Wingfield, chairman of the Hammersmith and Fulham GP Federation, suggested the STP was not equipped to tackle the health and social care problems facing the borough. He offered to form a ‘grand alliance’ between GPs, councillors and members of the community to confront local healthcare challenges.



 
Save Charing Cross Hospital meeting audience

 
Save Charing Cross Hospital campaigners



Monday 28 November 2016

Urgent meeting on NW London STP tomorrow Hammersmith Town Hall 7pm

From London Keep our NHS Public

Hammersmith and Fulham Council has announced plans for legal action against the NW London Sustainability and Transformation Plan  which aims to close first Ealing then Charing Cross Hospitals. Hammersmith & Fulhan  and Ealing Councils are the first to refuse to sign off the STP -  action we need replicated across England. In a step forward last Tuesday Hounslow Council passed a motion with all party support to retain acute services at Ealing and Charing Cross and a statement was signed by 5 councils including Harrow and Brent condemning the closure plan.The public meeting called by Hammersmith & Fulham Council tomorrow is vital in demonstrating the scale of public opposition and highlighting the need to protect local health services.



Monday 21 November 2016

Now Brent CCG gets into NHS estate management and development to further the STP


Last week Chris Hopson, Chief Executive of NHS Providers, warned that poor consultation over the NHS  Sustainability and Transformation plans could cause mass opposition on the streets that would scupper the plans LINK while Diane Abbott has referred to the STPs, quotuing that for NW London, as a 'dagger pointed at the heart of the NHS LINK.

One area that has not received much press coverage or comment is the management of the sites and buildings belonging to various parts of the NHS (see table above).

A report LINK going before the Community and Wellbeing Scrutiny Committee on Wednesday from the Brent Clinical Commissioing Group and NHS Propery Services, entitled the NHS Estate in Brent,  puts forward plans for various parts of the estate. They see the management of property as an 'enabler' to 'delivering' the STP and Shaping a Healthier Future. In particular they look at increasing the use of void space in the Willesden Centre and Monks Park Centre but also have far reaching plans elsewhere:
The CCG estates strategy identifies three site locations to be developed to support the local hospital and hub strategy. In order to maximise the use of the existing estate the CCG estates plans focus on creating out of hospital Hubs at Wembley Centre for Health and Care, Willesden Centre for Health and Care and Central Middlesex Hospital.
The three Hub locations were identified following an assessment of the main areas of deprivation and service demand across the borough. The CCG also took into account the forecast population growth.
The map below shows the forecast population growth in Brent to 2025.


Brent Population Growth 2015-25
This indicates the greatest population growth density to be forecast in the south west of the borough, suggesting the greatest health care demand in the areas are around the intended Hub locations at Wembley Centre for Health and Care and Central Middlesex Hospital

Wembley is the area with the second biggest capacity for new homes within North West London (11,500 new homes).
The Park Royal development on the border with Ealing has the potential for 1,500 new homes and new development proposals in Alperton will impact on south Brent and north Ealing, creating an increased need for primary care provision around Central Middlesex Hospital.
The majority of out of hospital services will be delivered from the Central Middlesex Hospital site which will become a Hub+. The Hub+ will offer specialist services commissioned for the whole borough alongside standard Hub services such as primary care, community services, one stop assessments and treatments and access to more complex diagnostics for the local population.
The Hubs at Wembley Centre for Health and Care and Willesden Centre for Health and Care will offer the standard Hub services for the local population.
The CCG is working with London North West Hospital Trust to develop a business case for the future configuration of Central Middlesex Hospital which will include the provision of a GP practice. The business case is due to be completed in summer 2017 and will then be submitted to NHS England for approval. It is anticipated that the GP practice (subject to commercial arrangements being in place) will be in occupation late 2017.
The business cases for Willesden Centre for Health and Care and Wembley Centre for Health and Care will follow after Central Middlesex Hospital. The aim is to maximise utilisation of both sites to deliver local services to the population in the area.
The CCG is working in collaboration with Brent Council to commission a property consultant to further their plans:  
  The One Public Estate (OPE) initiative is being delivered in partnership by the Cabinet Office Government Property Unit and the Local Government Association. The initiative provides practical and technical support and funding to Councils to deliver ambitious property-focused programmes in collaboration with central government and other public sector partners.
Brent Council, in partnership with the CCG, has made an application for funding towards the co-ordination of a data capture exercise and to undertake the public sector and health review. In working together to deliver a common local public sector estates vision, Brent Council officers working with the CCG have developed a project brief to be used for the purposes of commissioning a professional property consultant if the application is successful.
The projects identified are:
1.     Northwick Park Hospital Brent in partnership with the London North West Hospitals Trust, the University of Westminster and Network Homes, aims to rationalise services and resource and unlock development land to facilitate hospital redevelopment, new homes and improved services for the community. 

2.     Church End Growth Area Brent’s bid aims to enable the creation of a community hub that will attract public services and businesses to the local area, the key emphasis is ensuring that the public services and businesses provide positive services that will build capacity and benefit the local community. 

3.     Wembley The reduction in staff numbers and more efficient use of office space in Brent’s Civic Centre in Wembley Park, provides an opportunity to look more closely at how local public services may better work together, including a review of the area surround the Wembley Centre for Health and Care. 

Vale Farm area
4.     Vale Farm, Brent’s aim is to deliver a new multi-purpose leisure centre, new homes and possibly a new secondary school in an area that is primarily public open space and metropolitan open land, a feasibility study is proposed to identify opportunities for integration between local public sector services, particularly the Metropolitan Police, Brent CCG and the Council. 


A further bid will be brought forward for:
Brondesbury Road (including the Kilburn Square Clinic). These premises comprise 11-15 Brondesbury Road; which provides a home for community mental health teams. The site is Brent owned, but subject to shared usage with Central and North West London NHS Foundation Trust, (CNWL), (although current occupation circa 90% CNWL, 10% Brent). The model for the delivery of such services is under review, and is likely to result in a relocation of staff from the building.
The report states:
The CCG will build on the plans already in place to increase patient, user and carer engagement, which is essential for success as it makes the changes outlined in this paper. The CCG will do this in conjunction with the Council where this is appropriate.
Given widespread dissatisfaction with consultation on Shaping a Healthier Future and the NW London Sustainability Transformation Plan the Brent public may need quite a lot of persuading that these plans are in their interest.