Review of North Central London’s Start Well maternity and neonatal care: Reconfiguration proposals against the Mayor’s tests

As part of a role in collaborating with the NHS and other health partners on behalf of all Londoners, the Mayor of London developed six tests to apply to major healthcare transformation and reconfiguration programmes in the capital. The tests are designed to help challenge the NHS to ensure that major changes are in the best interests of all Londoners, with the six tests covering: inequalities; healthcare capacity; financial sustainability; integration with other care services including social care; clinical engagement; and patient and public involvement.

The Nuffield Trust has been involved in supporting development and evolution of these tests, including through the 2022 review of the Mayor of London's health inequalities test which resulted in that test being updated in November 2022.

In December 2023, the Mayor commissioned the Nuffield Trust to undertake a review of proposals by North Central London Integrated Care Board to consolidate maternity and neonatal care services within its geographic area. This report sets out our assessment of these proposals against all six of the Mayor’s tests, and is made in respect of materials published as part of the public consultation on the proposals, including the pre-consultation business case. The report also includes an updated assessment of the proposals now that the decision-making business case has been published.

In the course of undertaking this review we have benefited from the engagement we have received from North Central London Integrated Care Board, who have patiently explained their plans in greater detail to us and provided us with additional information. We are grateful for this generous assistance and the insights we have  been able to gather as a  consequence.