DRAFT Annual report and accounts, 2024 to 2025

Welcome and overview from the Chair and Chief Executive Officer

Welcome to the annual report for NHS South West London Integrated Care Board. This report is a record of our operation from 1 April 2024 until 31 March 2025.   

Our achievements  

Over the past year, NHS South West London has continued to work closely with our health and social care partners to respond to increasing demand for services, workforce challenges, and the rising cost of living. Despite these pressures, we have worked hard to deliver results against NHS constitutional standards and made progress in key areas.  

Reducing waiting lists has been a major focus for our NHS system, these efforts were nationally recognised when the Prime Minister and Secretary of State for Health and Social Care chose the South West London Elective Orthopaedic Centre (SWLEOC) at Epsom Hospital to launch the government’s elective reform plan.

We have made significant progress in tackling long waits, ensuring more people receive the treatment they need sooner. However, we acknowledge there is still more to do, and we remain committed to further reducing waiting times and improving access for all patients. 

Digital innovation continues to play a key role in our work to improve health outcomes and make services more effective. The expansion of virtual wards has allowed more people to receive care safely at home, while digital tools such as the NHS App have improved patient access and management of healthcare.

Promising early work at Kingston Hospital is exploring the use of artificial intelligence to streamline patient consultations, reducing administrative tasks and giving clinicians more time with patients. Our research partnerships have supported pilots such as the NHS England Proof of Concept Study on reducing digital exclusion through community pharmacies, the Health Foundation’s Accelerating Innovation initiative on embedding new healthcare technologies, and a Wellcome Trust-funded study evaluating patient safety participation.

We are still in the foothills of digital innovation, but we believe with advice and expertise from some of our new ICB Non-Executive colleagues in particular, this work will support our system to become more productive and provide better services for our local population.  

Meeting the needs of children and young people with special educational needs and disabilities (SEND) continues to be a shared priority across South West London. This year, all six boroughs worked together to strengthen support through a new governance structure and a fully staffed clinical leadership team at Place.

In partnership with voluntary sector organisation PlayWise, we co-ordinated and piloted a personalised Support Passport to improve transitions across education, health and care settings. In Richmond, the speech and language therapy service has supported this work by developing individual transition profiles with young people moving into post-16 education.

These profiles set out each young person’s experiences and any concerns they may have, and are shared with professionals in their new provision to support a smoother, more informed transition. We also developed a new data dashboard to support oversight and shared a youth-led film with health care professionals to highlight how young people with SEND want to access and experience care. 

Supporting and developing our workforce remains a priority. This year, we further developed successful initiatives such as the ‘Ask Auntie’ app, which provides ongoing support for international recruits, and our ‘Disability Advice Line’, which helps employers confidently hire and retain staff with disabilities.

We have supported 260 healthcare support workers through targeted training, creating clearer career pathways, helping them develop skills, and encouraging them to stay in South West London. We also supported 24 internationally educated nurses in achieving professional registration, reducing reliance on temporary staff and improving continuity of care.

Additionally, new partnerships with local colleges and community organisations have provided valuable work experience placements and outreach, encouraging thousands of students and local residents to pursue careers in health and social care. This initiative not only supports the NHS, it supports our communities into meaningful employment. 

Our system continues to be among the strongest in London for cancer care; we consistently perform well against national targets. We also have among the best GP patient survey results nationally, although we know access to primary care remains a challenge, particularly for some sections of our communities. 

We are addressing this by supporting our GPs to expand the primary care workforce with new roles, such as paramedics and social prescribing link workers, enabling patients to see the right health professional more quickly. 

Addressing health inequalities has remained a priority for our organisation. Our Health Inequalities Dashboard has allowed us to better understand where action is needed, helping us to improve maternity services, respiratory care, and mental health support with targeted NHS interventions.

These have included outreach and community-based programmes to improve access, early identification of at-risk groups, and improvements to services to better meet the needs of underserved populations.  

Prevention continues to be a core part of our work in South West London. This year, we delivered targeted programmes to reduce risk factors such as smoking, excess weight and cardiovascular disease, including the roll-out of the Tobacco Dependency Programme across all hospitals, reaching more than 6,000 patients.

We also expanded diabetes and heart disease prevention initiatives through structured education and lifestyle support, delivered thousands of community health checks, and increased uptake of screening and immunisation programmes. These efforts are helping people live healthier lives and reducing pressure on NHS services. 

We remain focused on strengthening care in the community, helping people stay well and independent in their own homes for longer. Across our six boroughs, local initiatives continue to make a tangible difference. Each borough is developing Integrated Neighbourhood Teams (INTs), tailored to meet local needs by bringing together GPs, social care, community health services, and voluntary sector partners.

Sutton’s INT has emerged as an exemplar for London, demonstrating how this collaborative approach can deliver proactive, coordinated care. Their targeted work on cardiovascular disease (CVD) prevention highlights how early intervention and close partnership working can save lives, effectively tackle health inequalities and improve long-term outcomes for patients. 

Although smaller in scale, we have also achieved success in some new appointments to our Integrated Care Board, with highly experienced and talented Non-Executives and two Associate Non-Executive Members joining earlier in the year.

We are fortunate to have some varied expertise and experience in digital transformation, healthcare innovation, finance, and strategic oversight bring fresh perspectives to our work, ensuring strong governance as we navigate the opportunities and challenges ahead. I know we will all immensely value the support these individuals will provide to our Board and system over the coming months in what will be a challenging time.  

Challenges  

As the first draft of this Annual Report was submitted through the assurance process, the Government announced the abolition of NHS England and the reduction of 50% of costs for Integrated Care Boards. Having successfully achieved the nationally required reduction in our management costs by 30% last year, this will undoubtedly be a huge challenge for us in the coming year.

We are determined to support staff through this next change and maintain our organisation’s focus on improving the health of our local population across our six places. We will be co-ordinating our response and future plans with our colleagues at London, with our partner ICBs and local authorities to make sure the best services are provided for the communities we serve. 

South West London remains a financially challenged system. We continue to work together across all parts of the NHS to manage costs while delivering safe care for patients and local people.

Over the past year, we have focused on improving productivity – ensuring resources are used as efficiently as possible and that every NHS pound delivers the best outcomes for patients. However, financial pressures remain, and we know that difficult decisions lie ahead as we work towards a more sustainable system.  

Demand for urgent and emergency care continues to grow, with this winter bringing some of the greatest pressures on our NHS services. While we have made progress, waiting times for urgent care remain challenging.

Through strengthened coordination between hospitals, primary care, community services, and social care – and highlighted through our Winter 10 case studies – local teams have worked hard, but we know there is still a great deal more to do.  

Access to primary care, NHS dentistry, and children and young people’s mental health services remains a priority for our communities. Through initiatives like our GP Improvement Plan, increased workforce capacity, and digital tools, we aim to further improve access.

We continue working with partners to address the national challenge of NHS dentistry availability, and we remain committed to reducing waiting times and providing better mental health support, particularly for young people and people in crisis.  

We face significant challenges with our NHS estate, with some facilities no longer fit for modern healthcare, limiting dedicated staff in providing the high standard of care patients deserve. We will continue to prioritise helping NHS staff work productively in the right environment within our available capital spending allocation. The delay to the Specialist Emergency Care Hospital in Sutton – announced by Government to begin between 2033 and 2035 – will require careful planning and investment to ensure patient safety.

We continue to focus on estate improvements across South West London, including NHS and GP premises, to ensure where we can, that patients are treated in the right environment and that staff can do their jobs unhampered by the buildings they work in.   

The way we work  

Strong partnerships remain essential to delivering for our communities and tackling the challenges we face. Collaboration across health and care organisations ensure that people receive joined-up support that helps them stay healthy, live independently, and access NHS care in the right place. Recognising the strength of our system, we continue to work closely with partners to develop our workforce, create career pathways in health and care, and maximise our role as an anchor institution.  

Engagement with our communities is key to shaping services that meet local needs. This year, our Winter Engagement Fund played a vital role in supporting NHS operational pressures by working directly with 115 voluntary and community organisations to reach more than 10,000 people across South West London.

Through targeted engagement, trusted local organisations helped communities access important information about services like the NHS App, Pharmacy First, and winter vaccinations, all aimed at reducing pressure on primary care and urgent care. The fund enabled conversations with people who often face barriers to accessing healthcare, helping them navigate the system and receive the right care at the right time.  

We also supported the national 10-Year Health Plan engagement, supporting the government-led process by gathering insights from local people, staff, and partners. Throughout the engagement, we worked with NHS organisations, the South London Listens programme, our Voluntary, Community and Social Enterprise (VCSE) partners, and system leaders to encourage participation and discussion. As part of this we hosted a listening event for our VCSE partners in January 2025, bringing together over 80 representatives from voluntary, community, and Healthwatch groups to explore what matters most to their communities.

In addition, a System Leaders Virtual Event saw more than 90 senior leaders from across health, social care, and the voluntary sector discuss how the national priorities relate to South West London. Staff engagement was also a key focus, with over 400 ICB staff taking part in discussions, alongside NHS trusts across South West London organising their own staff sessions, encouraging responses through the national Change NHS portal. Staff from Croydon Hospital Trust were also selected to take part in a London-wide engagement event in February 2025.

All feedback gathered through these sessions was submitted to NHS England via the Change NHS portal, ensuring that the voices of South West London’s communities, staff, and system leaders were represented in the national conversation.  

Our local and South West London level partnership with our six Healthwatches continues to grow and strengthen. Healthwatch insight reports have had an increasing impact over the past year, helping shape how we plan and design health and care services in direct response to local people’s views.  

Strengthening collaboration across the NHS and local government remains a priority, and this year we welcomed Leader of Kingston Council, Cllr Andreas Kirsch as the new Co-Chair of the South West London Integrated Care Partnership (ICP). The ICP continues to be a key forum for driving collaboration between the NHS, local authorities, and voluntary sector partners to improve health and care across South West London.   

Looking ahead  

As we look forward to 2025/26, we continue to face the dual challenge of managing day-to-day operational pressures while preparing for longer-term reforms, including the government’s forthcoming NHS 10-Year Plan and its focus on the three key shifts – moving care from hospitals to the community, making better use of digital technology, and focusing more on prevention.

This year’s NHS operational planning guidance places even greater emphasis on balancing financial constraints with improving patient care, requiring us to take urgent action to develop affordable and realistic plans that align with national priorities.  

In South West London, delivering a financially sustainable system remains critical. We will continue to prioritise improving efficiency, productivity, and value for money, ensuring that every pound spent delivers the best care for patients. As part of this, we are focused on making the best possible use of taxpayers’ money to protect and strengthen frontline services.  

At the same time, we are preparing for key national policy changes, including greater local autonomy for ICBs. These changes will help us prioritise areas most important to local communities, such as urgent and emergency care, primary and dental care, cancer and cardiovascular services, and ensuring babies and children have the best possible start in life.

Clinical leadership in decision-making will remain central to delivering these priorities. Integrated Neighbourhood Teams (INTs) are the model for delivering the shift towards community-based care, providing joined-up, proactive support that aligns closely with these national priorities. Our Place team and clinical leadership in Sutton are leading the way in London in proving how this model can make a difference for patients   

Preparations are underway for the delegation of specialised commissioning, transferring responsibility from NHS England to ICBs for services including cancer care, specialist mental health, and renal services. This shift will allow us to integrate these services more closely with local care, improving quality and tackling inequalities.

Early work has already demonstrated the benefits of a more joined-up approach, with pilot initiatives in renal care, bloodborne virus testing, and sickle cell services, showing how integrated commissioning can improve patient care. As we take on this responsibility, our focus will be on ensuring robust governance, financial planning, and workforce capacity planning to manage these services effectively while maintaining high-quality care for patients.  

Finally, we would like to take this opportunity to thank our partners, staff, and communities for their hard work and commitment over the past year. We also want to pay a special tribute to our outgoing Chief Executive, Sarah Blow, who retired after an exceptional 30-year NHS career, including eight years of leadership in South West London. Sarah has been a driving force behind the transformation of health and care services in our region, strengthening relationships with trusts, councils, and partners, and delivering better, more joined-up care for local people. We wish her all the best in her well-deserved retirement.  

We would also like to thank Dick Sorabji, who stepped down as a NEM in June 2024 to become Vice Chair of Central London Community Healthcare NHS Trust; Mercy Jeyasingham, who concluded her term at the end of December 2024; and Ruth Bailey, who ended her term earlier last year. We are grateful for their commitment and contribution to the NHS in South West London.  

We encourage you to read this annual report and reflect on our achievements, challenges, and future ambitions. As always, our success will continue to depend on strong partnerships, and we look forward to working together to create a stronger and more sustainable NHS that delivers for all our communities in South West London.  

Mike Bell, Chair

Katie Fisher, Chief Executive