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Tough challenges for London's NHS

A new report by the NHS Confederation’s London Relations Programme outlines the significant challenges facing the capital’s health service.

The paper, Capital challenge: improving healthcare in London, published on 2 September, says tough decisions will need to be taken if London’s healthcare is to continue to improve during the financial downturn.

Health inequalities and quality variation

It highlights particular issues around health inequalities and variation in the quality of services in the capital. It also says that large differences in the population’s life expectancy and social and ethnic diversity, coupled with high rates of teen pregnancy, mental ill-health and population mobility, present their own set of challenges for London’s healthcare services.


Significant improvements have been made to how care is provided in London. In particular the number of GPs has been increased, the rates of breast cancer have reduced, and access to many specialist services, like heart disease and stroke care, has improved.  However, there remain significant challenges to ensuring there is consistent, high-quality care throughout the capital and resources are managed effectively.

Commenting on the issues addressed in the report, NHS Confederation acting chief executive Nigel Edwards, said: “There is no doubt the NHS in London has made significant improvements in recent years, but we recognise there is more to do if all Londoners are to have access to the best quality care.

“Delivering the necessary improvements to London’s NHS services during a financially challenging period will doubtless prove a test for many organisations, particularly around public health and the health inequalities agenda which is arguably the capital’s number one health challenge.”

Higher demand

The NHS in London is expected to face a higher demand for services than the amount of financial resources available, and this is likely to put serious pressure on services over the coming years.

The report highlights a number of areas where savings could potentially be made without compromising quality, including a redesign of services, removing unnecessary duplication and working with partner organisations to reduce operating costs. Determining how best to make these improvements will require some difficult but necessary decisions, it says.

Honest conversations

Mr Edwards added: “Achieving these improvements will require some frank and honest conversations between local communities, patients and NHS staff about how services can best work for them.”

“In less than two years, all eyes will be on London for the Olympics. The NHS in London needs to capitalise on the changes taking place across the NHS to ensure their healthcare services are fit for a city with London’s international status.“

London Relations Programme

Download Capital challenge: improving healthcare in London and see our London Relations Programme pages for more information about the NHS Confederation's work with London members.

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