North West London integrated care system (ICS)


North west London ICS includes ten provider trusts, eight boroughs, eight clinical commissioning groups (CCGs) and 49 Primary Care Networks (PCNs). It covers a population of around 2.2 million residents in north west London.  Each organisation in the ICS works in close partnership to deliver the best care for residents.

What was the problem?

During the COVID-19 response, additional risks to black, Asian and minority ethnic (BAME) staff were identified.  Of the staff employed in north west London, 49% (over 26,000) are from a BAME background. BAME groups were over represented in the numbers of staff absence and deaths due to COVID-19.

Some of the emerging themes from staff engagement through BAME networks included high levels of anxiety, the need for a strong, collective approach from senior leaders and enabling honest, open, sensitive and safe conversations.

What was the solution?

Core principles were agreed at ICS level to be adopted at individual organisations. This included understanding cultural differences for example Filipino staff felt they could not refuse work requests they viewed as unsafe, putting themselves in harm’s way. Individually tailored risk assessments were identified as the foundation to protect all staff. It was made clear to all line managers that risk assessments were not a tick box exercise but were to enable open discussions and information gathering. This exercise led to the introduction of training for better personal protective equipment (PPE) use and proactive conversations on testing.

To enable wider access to information, webinars, self-assessment and best practice videos were created, which also supported colleagues in care homes and primary care.

What were the results?

All providers have implemented a consistent and robust risk assessment process for all staff, with risk assessments adapted to local clinical settings.  For the largest providers, staff are being prioritised based on identified risk factors including; staff in very high risk working environments, age 60+ and 55+ for BAME staff, males, people with underlying health conditions, pregnancy body mass index (BMI) and disability.

What were the learning points?

Having leadership support at chief executive level, with the passion and dedication to reducing inequalities is extremely important. Taking a system wide approach, through joined up working was an added benefit as it brought together wide and diverse thinking. Also, involving colleagues with lived experience had a direct impact on the approach and outcome. A new ‘story telling’ approach is now being applied across various sectors in the ICS.

Want to know more

Please contact Thomas Simons, director of human resources and organisational development (OD)

Charlotte Bailey, executive director of people and OD,

Del Mehet, associate director of workforce and OD,