Improving health and health care in London: Who will take the lead?

John Appleby Chief Economist, The King’s Fund

December 2011

• London health care 2010: Changing the future of services in the capital, The King’s Fund • Transforming health in London, The King’s Fund • Metropolitan Hospitals, Provident and Other Public Dispensaries and Charitable Institutions for the Sick Poor, House of Lords Select Committee report

Old reports:

New report published in December 2011

120 years of reviews of London’s health services

Healthcare for London: A Framework for Action Lord Ara Darzi, 2007

London PCTs 2011/12 allocation

London trauma centres

Summary indicators GP patient survey 2010 • London ranks bottom on 26 out of 31 patient experience measures of primary care

Current multi-site trusts and proposed mergers

‘Compared with the other nine regions, London has the lowest proportion of trusts that have achieved foundation trust status (38 per cent), and the highest number of trusts (26) still in the pipeline. The SHAs we spoke to in other regions agreed that, while some individual trusts in other parts of the country face similar problems, the concentration and complexity of challenges in London are not replicated elsewhere.’ National Audit Office (2011). Achievement of Foundation Trust Status by NHS Hospital Trusts. Report by the comptroller and auditor general HC (1516) (2010–12).

1: Patient choice and clinical commissioners leading change in a market 2: The NHS Commissioning Board leading change through planning 3: Local authorities leading change through health and wellbeing boards 4: Providers leading change through academic health sciences partnerships

Four options for taking forward change in London:

‘...nothing in the Bill explains how strategic change will be made to the NHS. With perhaps 300 consortia, how will the necessary changes be made on a regional level? The programme that I led, Healthcare for London, built an alliance of hundreds of clinicians and managers across the capital to improve care. It led to London becoming the world leader in stroke and cardiac care... How will similar improvements happen in future?’ Darzi, 2011 Speech, Second reading of the Health and Social Care Bill, House of Lords: Hansard 11 Oct 2011, Column 1493

Read the report

Improving health and health care in London: Who will take the lead? www.kingsfund.org.uk/london