London is falling behind the rest of the country for service quality despite launching its Darzi plan a year before other regions.

Fewer than half the NHS organisations in the capital have achieved a good or excellent score in the annual health check, compared with nearly two thirds nationally.

This is the first time London's quality of service score has slipped behind the rest of the country. It is now 16 percentage points behind the rest of the regions combined on the proportion of good and excellent organisations. Last year London was 11 percentage points higher and the previous year it was six points higher.

The best performing strategic health authority for quality of services was the North East, where no organisation was weak.

The most improved area was the South West, with a 13 percentage point fall in trusts scoring weak and a 30 percentage point rise in trusts scoring good.

The worst performing area was the South East Coast, with the lowest proportion of excellent and good trusts (38 per cent), as well as the highest proportion of weak (15 per cent) trusts.

The Healthcare for London plan, led by Lord Darzi before he was a health minister, was published last July - a year ahead of the regional plans that fed into the NHS review.

Some improvement

NHS London chief executive Ruth Carnall told HSJ: "Many of the things that have come out of the annual health check, like public health, access to GP services and choice, are absolutely what our Healthcare for London strategy is focused on delivering." She pointed out that London's use of resources scores had improved.

In total, 19 London organisations were classed as excellent, up from eight last year. The number of weak scores halved from 22 to 11.

She said the quality of services ratings proved the need to plough ahead with the controversial proposals in Healthcare for London, which include polyclinics and reconfiguring hospital services.

"The scores give us added leverage over people who want to hold us back," she said.

National targets

For core standards, London trusts performed better than the rest of the country, but it struggled with national targets.

The worst performance was on accident and emergency waiting times, GP access, inpatient waiting times, referral to treatment times and breast cancer screening.

London's PCTs were not reconfigured as part of Commissioning a Patient-led NHS and it has been suggested that their small size may be affecting their performance.

Ms Carnall said reconfiguration was "the last thing London needs" but said PCTs were organising themselves into seven commissioning clusters.

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