Launching in November 2021, the Start Well Programme was established to review and improve maternity, neonatal and children’s surgical services in North Central London – Barnet, Camden, Enfield, Haringey and Islington.
Led by NHS North Central London Integrated Care Board, on behalf of the health and care system, the programme has involved close working with patients, clinical leaders, staff and other stakeholders to develop proposals on the future shape of maternity, neonatal services and children’s surgical services.
Our collective ambition as a health and care system is to give babies and children the best start in life and improve outcomes for pregnant women and people.
The case for change
There are many areas of excellent care across North Central London, and staff work incredibly hard and are committed to achieving the best possible outcomes for patients. Through the Start Well programme we also found a strong clinical case for change. There are opportunities for us to improve the quality of services and health outcomes for local people, address health inequalities, and provide a better experience for our patients, their families, carers, and our staff.
Our case for change and case for change summary highlight that births across North Central London are declining and that services need to be able to meet the changing and more complex health needs of babies and pregnant women and people and also to address inequalities.
We are also working together with our maternity and neonatal service providers as a system wide partnership through the NCL Local Maternity and Neonatal System to improve services, make them safer, kinder and fairer for the people who use them.
Public consultation period
Between December 2023 and March 2024, NHS North Central London Integrated Care Board ran a public consultation, on behalf of the local integrated care system, and NHS England (London) Specialised Commissioning, to seek views on the proposals for maternity, neonatal and children’s surgical services.
Our consultation document provides further details about the options for consultation, why we put them forward, as well as what this means for people who use these services.
Consultation feedback
Over the 14-week consultation period, we heard a lot of detailed and thoughtful feedback from organisations, stakeholders, staff and residents, and are very grateful to all those who shared their views.
We received feedback and insights from more than 3,000 people, as well as contributions from interviews, focus groups, sessions with patients, staff and wider stakeholders, which have all shaped the decision-making process.
Our consultation methodology and activity report outlines the activities we undertook and the reach achieved during the consultation phase. All the responses we received were collated and analysed by an independent research organisation and published in two separate reports – one focusing on maternity and neonatal services and the other on children’s surgical services.
The Mayor of London also submitted a response to our consultation, informed by an independent review by the Nuffield Trust, using the Mayor of London’s ‘six tests’ framework. Further work was subsequently undertaken by the Start Well Programme to respond to the Mayor’s recommendations. We received a further updated response from the Mayor based on an independent report, which applied the six tests framework to the decision-making business case for the proposals. The report will be published on the Mayor of London website in due course.
Formal decision-making meeting
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:
- Start Well Decision-Making Business Case (DMBC) Maternity and neonatal services proposals
- Addendum to the NCL Maternity and neonatal decision-making business case
- Start Well Integrated Impact Assessment (IIA)
- Appendices to the Maternity and neonatal services decision-making business case