When Ruth Carnall took over as interim chief executive of NHS London in August 2006, she said she would manage it as though she were there for the long term.

She has seen through changes initiated by NHS chief executive David Nicholson, including setting up the Provider Development Agency with the specific aim of steering all trusts in London towards foundation status. Ms Carnall said: 'We are keen to see foundation trusts established in London quickly.'

She has also set up the London commissioning group to strengthen commissioning and. separate it from provider issues.

She explained: 'We want to be really transparent about the nature of the challenges facing us.'

This has gone down well with primary care trusts. One chief executive said: 'We are working together very effectively, although we are slightly champing at the bit to get on with things.'

A review of London's NHS, commissioned from Professor Sir Ara Darzi, is due in late April or early May.

It will set out the strategy for maintaining the capital's world status as a centre of research and treatment excellence while tackling health and service inequalities.