Start Well Programme Supporting Documents

This page outlines each of the key phases of the NCL Start Programme and related supporting documents.

 

On Tuesday 25 March 2025, recommendations for the future of maternity and neonatal services in North Central London were agreed at a formal meeting of North Central London Integrated Care Board (NCL ICB) where they were joined by NHS England Specialised Commissioning, as co-commissioners.

The agenda, full decision-making business case and supporting documents are as follows:

In November 2024, we published two independent reports summarising the responses received to our consultation into proposed changes to maternity, neonatal and children’s surgical services.

 

We held a public consultation in North Central London from 11 December 2023 to 17 March 2024. The following documents were published to support the 14-week consultation process:

 

In July 2024, the following post-consultation documents were published:

  • Start Well programme consultation methodology and activity report – this report outlines the approach taken to consultation, the activities undertaken and the reach achieved.
  • Consultation interim findings – this is an interim report written by the independent organisation who analysed the consultation feedback. It provides high level emerging themes on the three elements of the proposals and highlights several areas where further work is needed before agreeing how to proceed and to ensure that feedback received during the consultation is taken into account.
  • Start Well programme proposed next steps – this report outlines the additional work that will be taking place following the public consultation and review of emerging themes and were subject to ICB Board approval at the meeting on 23 July 2024.

 

 

  • Maternity and neonatal services interim integrated impact assessmentand Paediatric surgery interim integrated impact assessment : An integrated impact assessment is a document to assess whether something we are planning to recommend might have unintended consequences, including impacts on particular groups of people, on the environment in which they live, or other unforeseen impacts that may need to be mitigated. These interim IIAs were published alongside the ICB Board papers on 28 November 2023, and considered by NCL ICB Board at its public meeting on 5 December 2023. They were separately considered by NHS England as part of their decision making. They will inform the approach to public consultation and will continue to be updated after the consultation.

 

  • Maternity and neonatal services pre-consultation engagement report: Over the summer of 2023, the Start Well programme conducted engagement about maternity and neonatal services to identify potential impacts changes to services might have. This qualitative research was independently evaluated, and this document is the independent report of the findings of the engagement. The findings were used to inform the proposals including the interim integrated impact assessments.

 

  • London Clinical Senate review – North Central London Start Well programme: A review by the Clinical Senate is an integral part of the process for all major service change in the NHS. The review has a focus on ensuring that there is a clear clinical evidence base for the changes proposed, which is a key test for NHS major service change. The Clinical Senate review of the Start Well programme took place in July 2023 and the report of their findings was finalised in November 2023.

 

  • Start Well case for changeand Start Well case for change summary: This was the first formal stage of the Start Well programme, development of which took place from November 2021 to June 2022.  Based on feedback from clinical staff and extensive data analysis – with a strong population health focus – the Start Well case for change identified what currently works well in maternity, neonatal and children and young people’s services in NCL and the areas where there are opportunities for improvement.  It did not seek to set out potential solutions.  It was approved by NCL CCG Governing Body (the predecessor body to the ICB) on 30 June 2022 with an agreement to start a period of engagement on its findings.

 

  • Start Well case for change engagement report:Following approval of the case for change in June 2022 a 10-week programme of engagement started on 4 July 2022. The engagement had two aims. Firstly, to identify whether the themes highlighted in the case for change resonated with patients, residents, staff and stakeholders. Secondly, to capture the views of patients, residents, staff, and stakeholders on the opportunities to improve care in NCL. The feedback from the engagement was independently evaluated and a report of the findings was published in September 2022. The feedback was used to inform the proposals.

 

  • NCL ICB Board of Members: Start Well paper, 22 November 2022and NCL ICB Board of Members: Start Well paper, 28 March 2023: These papers set out proposed future care models for both maternity and neonatal care and children and young people’s hospital care. At their public meeting in November 2022, the ICB Board agreed to start an options appraisal in relation to the implementation of the proposed maternity and neonatal care models and the proposed emergency and planned surgical children and young people’s care models. A further report in March 2023 report updated the recommendation in respect of proposed emergency and planned surgical children and young people’s care models.

 

  • Proposed children’s surgical pathways by specialty: This document sets out the proposed future children’s surgical pathways by age and by specialty. It is an appendix to the paediatric surgery pre-consultation business case and reproduced separately here as it is referenced in the consultation document.

 

 

  • Letter to NCL Joint Health Overview and Scrutiny Committee 15 March 2024: We wrote to NCL Joint Health Overview and Scrutiny Committee (JHOSC) in accordance with The Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013, to notify the NCL JHOSC of the date by which we need the committee to provide comments on our proposals for maternity, neonatal and paediatric surgical services under the 2013 Regulations. Additionally, we informed the committee of the date by which we intend to make a decision about whether to proceed with our proposals.