Last week saw the launch of Healthcare for London: A Framework for Action, the findings of a review led by Sir Ara Darzi, chair of surgery at Imperial College.1 The review was commissioned by NHS London in 2006, but its contents have assumed a greater significance with the recent appointment of Sir Ara as a junior minister, charged with a wider review of the health service throughout England.2 The terms of reference for that review make clear the government's determination “to ensure that the future of the NHS is clinically led” and that vision is pre-eminent in his London report.

The review has been based largely on the views of clinicians, concentrated into six working groups of “clinical innovators” drawn from a range of organisations, including the King's Fund, to look at clinical pathways. They looked at maternity and newborn care, services for staying healthy, acute care, planned care, long term conditions, and end of life care. …