A health commissioner post should be created in London to coordinate the work of councils, clinical commissioning groups and Public Health England, a panel of health experts headed by former health minister Lord Darzi has suggested.
The London Health Commission also called for a five year plan to invest £1bn in the capital’s GP practices, many of which require rebuilding or refurbishment.
Lord Darzi has recommended the commissioner be appointed by mayor Boris Johnson, who they would directly report to.
The commissioner would encourage closer working between local councils, CCGs, Public Health England and NHS England.
The role would also involve overseeing public health recommendations made by the commission, which include piloting a minimum price for alcohol, restricting junk food outlets near schools and speeding up air quality measures to reduce pollution.
His report suggests GP surgeries should open for longer, from 8am to 8pm, and form networks to reduce “professional isolation”.
It also calls for more rigorous care standards to be set and enforced across primary care. It proposes a significant increase on charges imposed on derelict hospitals, in a bid to force trusts to use their estates for patient care or release them for housing.
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The commission is concerned that NHS facilities funded through private finance initiatives are underused. It also said hospitals should be allowed to use part of their land to build affordable housing for staff and key workers.
Centres of excellence for cancer and heart disease should be created, it added. The commission also calls for the NHS in London to deliver the lowest death rates in the world for cancer, heart diseases and respiratory illness.
There would be a further drive to close the gap in death rates between those who are admitted to hospital on weekdays and those admitted on weekends.
The report focuses on the role of technology in improving health outcomes, with a call for 50,000 new jobs to be created in the digital health sector.
Panel members on the commission include Anne Rainsberry, NHS England regional director for London; Ron Kerr, chief executive of Guy’s and St Thomas’ Foundation Trust; and Matthew Patrick, chief executive of South London and Maudsley Foundation Trust. The commission heard from experts across the health sector, as well as 15,000 Londoners, before making its recommendations.
A further recommendation is that, under a pilot, women receiving maternity care should be given control of 12.5 per cent of the budget relating to their care. If they are unhappy with the care received they could withhold this amount from the maternity unit where they were treated.
The intention is to make providers focus, and improve, poor care. Maternity has been chosen for the pilot because this is the area where care has been “stubbornly poor”, the commission argues.