Most London primary care trust clusters were behind on their savings plans at the end of the first quarter of this year. The figures were revealed in an internal NHS London document on the progress of local efficiency programmes.

The report came from the strategic health authority’s delivery group meeting in July, and was released to HSJ under the Freedom of Information Act.

Read the NHS London report

It gives the most complete picture yet of how successful PCT clusters have been in implementing the quality, innovation, productivity and prevention challenge.

The document shows that at the end of quarter one London as a whole was £2.6m behind on its savings, against a target of £59.8m, with a forecast outturn £11.3m short of the £445.5m planned saving.

Only north central London and inner north east London had fully hit their savings targets - although south west London, despite not realising all planned savings, had met all of its process milestones.

The report said: “The financial figures suggest that clusters are already reporting some slippage in achieving their QIPP savings for this financial year. Although generally clusters tend to backload their plans to deliver most saving towards the end of the financial year, usually in quarter four.”

Outer north east London had a “particular problem”, with Waltham Forest PCT forecasting it would meet only two thirds of its QIPP total for the year. The gap would have to be made up by releasing reserves.

Of the capital’s 129 local QIPP programme milestones which should have been met by the end of quarter one, 22 had been missed.

Much of the delay was short term and could be blamed on trusts “awaiting additional guidance or agreement for a particular programme”.

However, one exception was in Bexley, where the implementation of best practice in diabetes care was delayed because a “previously agreed service specification was felt to not be fit for purpose” and was being reworked.

Other hold-ups included an out-of-hours primary care strategy in outer north east London, which was pushed back six months, and an integrated heart disease service in Southwark delayed by three months due to recruitment problems.

The report also said most cluster QIPP workstreams could be placed into one of five categories. These were: productivity, typically in mental health and primary care; integration, often in long-term conditions, end of life and maternity services; reducing drugs costs; running costs; and activity management.