As part of his role in working with the NHS and other health partners on behalf of all Londoners, the Mayor of London has developed six tests to apply to all major transformation and reconfiguration programs in health and care, designed to help challenge the NHS to do this Demonstrating major change is in the best interests of all Londoners. The Nuffield Trust has supported the development and refinement of these tests and carried out a review of the Mayor of London’s Health Inequalities Test which resulted in them being updated in November 2022.
As a potential major update to the capital’s healthcare system, the proposed Orthopedic Elective Care Center in North West London is eligible for assessment under this framework. In January 2023, The Nuffield Trust evaluated the proposals against the first four of the Mayor’s “six tests” for major service reconfigurations. This analysis was used by the mayor to support his response, which was broadly positive but called for some changes and clarifications, particularly in relation to health inequalities and staffing.
In March, following the publication of the consultation report4 and the availability of the London Clinical Senate review of the proposals, we completed tests five and six. On March 15, the final pre-release version of the Decision-Making Business Case (DMBC) was made available to the GLA and the Nuffield Trust to reflect changes made since the PCBC and in light of the Mayor’s earlier response and the public consultation and input from the Clinical Senate.
This final report from the Nuffield Trust supplements the original report on the first four tests with tests five and six and adds a further comment (in red) indicating where NWL NHS has changed plans or otherwise responded to questions since the PCBC, raised during the consultation period.
Gainsbury S and Davies M (2023) Evaluation of the proposed North West London Orthopedic Elective Supply Center using all six Mayor’s Tests. Research Report, Nuffield Trust.