Editorials

Leading healthcare in London: time for a radical response?

BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f4711 (Published 29 July 2013) Cite this as: BMJ 2013;347:f4711
  1. Naomi Fulop, professor of health care organisation and management,
  2. Rosalind Raine, professor of health care evaluation
  1. 1Department of Applied Health Research, University College London, London WC1E 7HB, UK
  1. n.fulop{at}ucl.ac.uk

King’s Fund report should have been even more radical

London’s health services have not been short of reviews, blueprints, and plans over the past 20 years.1 2 The latest, published by the King’s Fund,3 describes the current healthcare landscape across London within the context of the new NHS and the progress made in implementing Lord Darzi’s recommendations in his 2007 report, Framework for Action.2 Developments in London since 2011 are outlined in this new report. Most notable is the step change in outcomes for patients with stroke, after the major reorganisation of stroke services.4 The attempts to integrate services across whole systems are also described, but it is too early to assess their effect.5 However, we do know that London compares poorly with the rest of England with respect to its hospitals’ progress towards foundation trust status, proposed service reorganisations continue to falter in the face of sustained public opposition, and Lord Darzi’s vision to deal with the variation in quality of primary care has gained little momentum. In sum, the NHS in London is already in a “difficult situation” at a time when it is also …

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