NW London update
NW London System Update: June 2025
Foreword

A message from Rob Hurd CEO

As we move through a period of significant change, I want to thank you for your continued leadership and commitment to improving the health and wellbeing of our residents. This update highlights the tangible impact our work is having in communities across North West London; from cancer diagnosis and urgent care improvements to grassroots initiatives tackling health inequalities.

It also reflects how we’re listening to our residents, shaping services with their input, and preparing for the future through system collaboration, infrastructure investment, and organisational transformation.

I hope this summary gives you a clear view of both the progress we’re making and the priorities that lie ahead as we continue working together to create a healthier, fairer future for all our communities. 

Improving health and care for our residents
Across north west London, we continue to focus on improving health outcomes and service performance for our 4.5 million residents.
  • A&E Performance: In April, London exceeded its plan for the proportion of patients seen within four hours in A&E (80.2% vs 78% target). However, Type 1 performance remains below target (62.1% vs 64.7%).
  • Elective Care: While there’s been sustained progress in reducing long waits, challenges remain in specific specialities like neurosurgery and ENT. As of March, 123 patients were waiting 65+ weeks for treatment. Focus has shifted to improving 18-week and 52-week wait targets.
  • Cancer Diagnosis: The Faster Diagnosis Standard was exceeded (81.5% vs 75% target), but 62-day cancer treatment targets continue to be a challenge (74.5% vs 85% target).
  • Hospital Discharges: 830 patients remained in hospital at the end of March without meeting the criteria to reside, compared to a target of 335.
  • Cervical Screening: Uptake in 26–49-year-olds rose slightly to 56.1%.
  • Financial Position: The ICS is £4.5m behind plan at month 2, due to a provider deficit of £6.9m, partially offset by a £2.4m ICB surplus. Forecast remains breakeven. 
Working with communities to shape better health
Westminster Healthy Communities Fund

Through co-production with residents, we’re investing in initiatives that improve wellbeing and tackle health inequalities. Nearly 70 voluntary and community sector organisations are delivering impactful, community-led health projects, including:
  • Fitness groups to increase activity and reduce isolation
  • Healthy cooking classes
  • Mental wellbeing support and mindfulness
  • Peer-led health coaching and service navigation.
These initiatives focus on prevention and healthy living - improving heart and lung health, supporting mental resilience, and helping people live longer, healthier lives – adding life to years.

Looking ahead: 2027 and beyond

Plans are in place to sustain and expand this work beyond 2027, by:
  • Investing in VCS capacity and training
  • Embedding commissioning guidance in grant funding
  • Enabling more groups to become trusted public health partners
  • Expanding networking opportunities and peer learning
  • Embedding commissioning guidance into small grants programmes
  • Enabling more community groups to become trusted public health partners
  • Strengthening long-term relationships to sustain healthier communities.
A key goal is to build on the success of the Healthy Communities Fund and ensure its positive outcomes last well beyond its initial funding cycle.

Together, we are creating a stronger, more resilient public health system - rooted in community, driven by partnership, and committed to long-term wellbeing for all.


Resident Feedback: North West London Residents' Forum 
 
The June 2025 North West London Residents’ Forum focused on two central topics: The Shared Needs Assessment (SNA) and changes to the Integrated Care Board (ICB). These served as gateways into a broader conversation about health needs, service planning, and community involvement.  Feedback included:
  • the importance of including neurodiversity, dementia, and carers in planning
  • a strong desire for joined-up, personalised services
  • questions around how the ICB restructure will affect neighbourhood-level support and collaboration with local authorities and VCS organisations.

 Planning for the future: System change and organisation 
As you will be aware, ICB operating model discussions continue at national level and following recent national moderation meetings, discussions are underway between North West London and North Central London ICBs to explore a potential merger. No decisions have been made.

PA Consulting has been appointed to support the development of a detailed options appraisal, which will go to our July Board.

Any future changes will prioritise better outcomes for residents, maintaining strong local working relationships while enabling innovation and efficiency at scale.

Separately, I informed the Board at our meeting in May of my intention to step down, aligning with the appointment of a new Chair and upcoming ICB changes. I intend to remain in post until transition arrangements are finalised.

The way in which ICBs operate will see us focus on strategic commissioning and working in a different way to deliver what is required for our residents. From my point of view these changes along with the appointment of a new Chair provide a logical time to hand over the reins.

I am very grateful for the privilege of serving as a system leader in North Central and North West London Health and Care for over eight years. I am proud of the work that we have done to make North West London such a high performing and successful system and thank colleagues for all of your support over the years. Financial Position: The ICS is £4.5m behind plan at month 2, due to a provider deficit of £6.9m, partially offset by a £2.4m ICB surplus. Forecast remains breakeven. 

Capital and Estates
The Joint Capital Resource Use Plan 2025/26 is published and sets out the £435m investment plan for 2025/26, focusing on new builds, maintenance, net zero, and digital.
  • Primary Care Improvements: Over £5m is allocated for GPIT upgrades, estate improvements, and infrastructure funding (e.g. digitising records in 47 practices, adding 338,400 appointment slots annually).
  • Community Infrastructure: Projects such as the new South Kilburn facility and CIL bids in RBKC reflect strong joint working with local authorities.
  • Rates Recovery: Over £1m recovered to date will be reinvested in primary care estate initiatives.
The major risks to achieving the capital plan include low cash balances, fluid NHS guidance, challenging revenue positions, aging estates, and inadequate primary care premises.

Work continues on exploring neighbourhood health hub requirements and interim solutions following changes to the New Hospital Programme. Strategic Estates are continuing to:
  • collaborate with primary care and Trusts to rationalise unused or unfit-for-purpose estate (e.g. handing back areas of St Charles and sub-letting space at the Marylebone corporate office)
  • prioritise and address primary care leases with appropriate solutions, explore One Public Estate (OPE) opportunities with local authority partners, proactively manage expiring NHS property company asset leases,
  • conduct restacking activity for underutilised spaces across NHS Property Services estate (e.g. Alexandra Avenue, Park Avenue, Heart of Hounslow),
  • deliver existing inflight projects (e.g. the Northwood & Pinner health centre rebuild project for primary and community care).
A priority between June and March 2026 will be the delivery of one-off Utilisation & Modernisation Funding (£4.2m to complete by December 2025) and London Improvement Grant Funding (£1.07m to complete by March 2026). The funding will be put towards digitisation of medical records for 47 practices with a number of practices also receiving conversion of space or installation of teleconsulting pods to improve clinical or patient-facing capacity. It is calculated that an additional 47 clinical rooms would result in circa 338,400 additional appointments per annum.

Work progresses with ICS partners to inform local authority Local Plans and their respective Infrastructure Delivery Plans (IDPs). The current boroughs of focus are; RBKC, Hillingdon and Hammersmith & Fulham.

This month, Community Infrastructure Levy (CIL) bids are being submitted to RBKC to secure funding to support development of new primary care facilities for the new Newcombe House development and Foreland Medical Centre, which serves many patients impacted by the Grenfell fire.

A review of historic rates reimbursements recovery is in motion, led by the NHS North West London Estates Team. This is expected to deliver a significant financial return to NHS North West London which will be ring-fenced and reinvested back into primary care-related estates initiatives.

To date, over £1m has been reclaimed. These funds will be reinvested towards installation of temporary portacabins to support primary care delivery and one-off reimbursements cost pressures.

Estates projects due to complete this month include the delivery of a new primary care facility in south Kilburn, which will replace a poor quality residential GP site (June 25 - Brent). This project has been co-funded by NHS North West London and the local authority, with £1.8m in CIL funding being secured.

Sustainability
Work continues across NHS North West London and Trusts to complete Green Plans and meet the July submission deadline.   
 
ICB and Trusts colleagues are working proactively to tackle the consequences of climate change by piloting of the new Climate Change Risk Assessment Tool (CCRA) that will help identify vulnerable infrastructure and service risks in light of changing climate conditions, implement appropriate mitigations, and better understand the financial impact.  
 
A ‘Making the Difference’ event, hosted by the regional Greener NHS Programme Team and London ICB Leads, took place in June to celebrate all of London’s contributions to date in the Sustainability sphere, and included a range of guest speakers from across the NHS and partnership organisations. 
 
North West London Trusts have secured £78.3m of Public Sector Decarbonisation Scheme funding across the last four bidding rounds. This funding is largely being used towards heat pumps and de-steaming activity across hospital sites.  
 
This month, Imperial College Healthcare NHS Trust also received further funding from the Nitrous Oxide Funding Scheme to mitigation activity at the Western Eye Hospital. 

NHS oversight framework
The NHS Oversight Framework 2025/26 has been published and sets out how NHS England will assess providers and ICBs, alongside a range of agreed metrics, promoting improvement while helping NHSE identify quickly where organisations need support.

The framework will be reviewed in 2026/27 to incorporate work to implement the ICB operating model and to take account of the ambitions and priorities in the 10 Year Health Plan.

The framework is supported by a focused set of national priorities, including those set out in the planning guidance for 2025/26.

A set of metrics, which reflect the 2025/26 NHS priorities and operational planning guidance, will contribute to the segment score for an organisation. Each provider will receive an individual organisational delivery score one (best) to five (worst) based off its performance against 28 metrics.

ICB performance will be reported against the full suite of oversight metrics, but a comparative rating will not be issued. The framework states that is because it will be a year of significant change for ICBs as they transform in line with the Model ICB Blueprint to focus on strategic commissioning and implement plans to meet the running cost reductions.