STAKEHOLDERS: SWL ICB staff plus Integrated Neighbourhood Teams (INTs), 174 GP practices and 39 PCNs, and six Local Authority Public Health Teams (Croydon, Kingston, Merton, Richmond, Sutton, Wandsworth).

REDUCING PRIMARY CARE BURDEN: Combined/integrated auto-populating referral form mirroring referral criteria, embedded into SystmOne and EMIS used in SWL; the form captures preferred contact method to reduce chasing of non-responders; provider supplies an information sheet (contact details, service/pathway/process info) for GPs to use when considering, offering and making a referral, supporting patient decision-making.

F2F LOCATION PLANNING: Provider liaises with SWL ICB and Local Authority Public Health teams to identify local assets close to transport routes and parking opportunities.

KEY LANGUAGES (top non-English by borough): Croydon - Tamil, Polish, Gujarati, Urdu, French (then Portuguese, Turkish); Kingston - Tamil, Korean, Arabic, Polish, Bulgarian; Merton - Tamil, Polish, Portuguese, Urdu, Spanish (4.69% speak a European language); Richmond - Spanish, Polish, Turkish, Italian, Portuguese; Sutton - Tamil, Polish, Urdu, Bulgarian, Romanian (80+ languages spoken; 17% of households have members whose first language is not English); Wandsworth - Spanish, Italian, Urdu, Portuguese, Polish.

SUMMARY LANGUAGES: Tamil, French, Gujarati, Korean, Urdu, German, Polish.

KEY ETHNIC COMMUNITIES: Black African, Black Caribbean and South Asian. CORE20 AREAS

BY BOROUGH: Croydon - Croydon North, New Addington, Fairfield, parts of Coulsdon (population 390,800); Merton - Pollards Hill, Figges Marsh, Lavender Fields, Cricket Green, Ravensbury (29,000 of the Core20 population in East Merton); Sutton - Roundshaw (Beddington), St Helier & Wandle Valley, Sutton Central with focus on Belmont (Shanklin); Kingston - Norbiton, Beverley, Berrylands; Richmond - Ham, Petersham, Richmond Riverside; Wandsworth - Tooting, West Hill North, Furzedown, Roehampton, Falconbrook, Shaftesbury, Queenstown, Battersea Park. APPROACH: Data-driven, focused on working with communities disproportionately impacted by health inequalities; provider must work with SWL ICB to use further data on groups with poorer health outcomes to improve Healthier You outcomes.