London’s “complex and cluttered” health and care system is holding back plans to improve the health of its population, finds a new independent report from The King’s Fund.

The report, Sustainability and transformation partnerships in London, commissioned by the Mayor of London, looked at the progress made over the past year by London’s five sustainability and transformation partnerships (STPs), set up to help evolve and improve services.

While there is evidence to show improvement in some services, London’s STPs “are less advanced than those in many other parts of England” it found.

STPs in London have spent much of the past year “trying to overcome the challenging process by which they were introduced”, focusing on the internal workings of the partnerships, building relationships with their partners and addressing gaps in staff and public engagement, according to the report.

Taken together, the complexity of London’s health care system*, its rapid demographic growth, workforce shortages, and severely constrained NHS and local authority funding are presenting a unique challenge for STPs in the capital, which need to be addressed, it argues.

“London is home to world-class health and care services but also faces significant demographic, operational and workforce pressures. Its five STPs have a crucial role to play in working alongside NHS bodies, the Mayor and the boroughs to improve services for patients but are currently trailing behind STPs in other parts of the country,” commented Helen McKenna, one of the report’s authors and Senior Fellow at The King’s Fund.

“While progress is being made in improving services at a borough and neighbourhood level, the STPs need to do more to demonstrate their impact. Now is the time to review London’s complex and cluttered organisational landscape and develop a clear and compelling vision for the future of health and care for Londoners.”

* In addition to five STPs, London’s health and care system includes 36 trusts and foundation trusts, 32 clinical commissioning groups, 33 borough councils, the Mayor and Greater London Authority, 33 health and wellbeing boards, three academic health science networks, the London Health Board, London Strategic Partnership Board and Healthy London Partnership, and the regional outposts of several national bodies.