Pathway was pleased that the London Health Commission made reference to our submission and some of the issues we raised in their ‘Summary of the call for evidence’, published with much publicity on Monday 31 March.  The London Health Commission, Chaired by Lord Ara Darzi, was set up by the Mayor, Boris Johnson, to come up with answers to the big health issues facing London’s population.  It is due to produce a final report in autumn this year.  This first report summarises some of the evidence they have collected so far.

The LHC summary report includes a good section on health inequalities, as well as a substantial focus on the need for more integrated, patient centred care. It seems clear that many respondents were worried at the lack of strategic direction in London, and the absence of any clear city-wide decision making structures across the capital’s NHS.  Homeless patients, and other extremely excluded population groups, are particularly in need of more integrated health services.  As one of our clinical colleagues puts it: “Our patients don’t fall through the gaps between services, they are hammered into them.”

Pathway gives the ‘call for evidence report’ a cautious welcome therefore. The Commission seems to recognise that some groups, like homeless people, and some health issues, like managing TB, demand a far more co-ordinated, urgent and city-wide health response than they currently get.   We look forward to engaging on the next phase of the Commission’s work, when it is challenged to come up with answers to the problems it has identified.  Pathway thinks that the LHC should make the commissioning of specialist homeless health services across the city a clear priority.

Some of our initial submission is quoted on page 20 of the report:

“For London, the deep exclusion of our patients, and the balkanised commissioning and borough boundaries, can leave homeless patients with chronic and acute poor health badly served by our universal, free health service. If London does not find ways to improve health outcomes for homeless patients it cannot reasonably be said to meet the new duties on health inequalities. We know that homeless people have some of the worst life chances of any group – with extreme early mortality very common.”