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General practice in London: meeting future challenges

There are significant variations in the quality of primary care in London, according to a new report commissioned by NHS London from The King’s Fund and Imperial College London. The report was featured by a number of media outlets, including the BBC and Pulse. General practice in London faces unique challenges - its population is more transient and diverse, with hundreds of different first languages spoken. It is also growing faster than elsewhere in England. While on some measures Londoners are healthier than people from other parts of the country, widespread inequalities exist, with life expectancy varying by up to nine years and infant mortality three years between different parts of the capital.

The report highlights some examples of excellent performance - for example, some deprived parts of the capital have the highest rates of child immunisation in the country, and London practices have made good progress in adopting new information technology. However, Londoners also report lower levels of satisfaction with GP services than patients elsewhere in the country - for example, they are less satisfied with access to services, the quality of consultations and support for managing long-term conditions. The report argues that major changes are needed to the organisation and delivery of primary care to meet these challenges.

Dr Christopher Millett, a co-author of the report, from the School of Public Health at Imperial College London, said: "Improving the quality of primary care in the capital is vital for containing healthcare expenditure and for improving the health of all Londoners. While this report highlights many examples of excellent care, more needs to be done to reduce variations in performance across the capital. The report also highlights the need for far greater focus on disease prevention in London primary care, both by increasing advice and counselling to individual patients and by working closely with local government to reduce smoking, alcohol misuse and obesity in local communities."

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