The next major challenge facing the system is the number of people who are in hospital who don't need to be there because there is currently no alternative.
Currently, too many older people are admitted to hospital when, with appropriate out of hospital care, they could be treated in the community and looked after in their own home. Around 25% of patients could be looked after in their homes or supported in the community.
A move to more out of hospital care would improve quality of care and save money. For every £1 spent in hospitals, alternative community care can be provided for 70p.
In North West London we have consulted on a large out of hospital investment strategy as part of Shaping a Healthier Future and over the past year we have been doing both the planning and delivery of these changes.
Over the next five years, we will be investing £190m more a year across North West London on out of hospital services, including integrated care and more access to general practice. These investments will result in more staff and better facilities to deliver it.