Leading health care in London: how will the new NHS and public health system work?

Local service design

Part of Health and health care in London

The new NHS and public health system in London is still taking shape, but the complexity of the emerging eco-system is apparent.

Principal formal relationships between health bodies in London

Graph showing the principal relationships between health bodies in London

See also: An alternative guide to the new NHS in England

What are the challenges for this new NHS system?

The absence of a designated system leader in London means that there will need to be a process of mutual adjustment when aligning a large number of participants, networks of both individuals and organisations, and stakeholders from different sectors in the new system, sometimes with quite different objectives.

The NHS lacks experience in implementing improvements in an eco-system because change has more typically occurred through concentrated leadership. In rising to the challenge of managing change in the new environment, everyone involved will have to learn how to handle the new arrangements and many will have to adjust to different roles, relationships and ways of working – while also dealing with growing and unprecedented financial and service pressures.

This figure first appeared in our report: Leading health care in London: Time for a radical response

Related content

Leading health care in London: Time for a radical response

Our report on health care in London asks where responsibility for leading improvements will rest in future and argues that the new NHS structures are unlikely to provide the leadership needed to meet the challenges ahead.

Completed project

Health and health care in London

We have a long history of supporting the development of health care in London, dating back to our roots working with the capital's voluntary hospitals. Find out about our work on health care in London.

London acute hospitals and their configuration

Service reconfigurations have now been proposed for each of the London sectors. This information relates to developments since December 2011 and first appears in the appendix of our report, Leading health care in London: Time for a radical response.

Patient care under threat as pressures mount on London's NHS

London's NHS faces growing pressures, with services in urgent need of change, according to a new report published today by The King's Fund.

A radically different approach is needed to improve London's NHS

The financial and service challenges facing the NHS in London will not be met by the new NHS organisations established in April. This is the stark conclusion of our updated analysis of health care in London.

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