Community trusts are part of the solution for primary care in London

The Turnberg review came in time to re-kindle the embers for primary care in inner London, which had been impervious to national developments in primary care, such as GP fundholding. Together these reports are a crucial building block for the new London region in taking on the primary care development baton.

But I was surprised by the review's lack of consideration of the significant role community trusts played in delivering the programme's aims in partnership with health authorities, general medical services and others despite the internal market. The creation of dedicated community trusts was a piece of Tomlinson's Making London Better policy. Playing our part in Wandsworth's primary care development plan was certainly a key raison d'etre of my trust, which devoted 15 per cent of its resources to the programme. It would be helpful to know whether the unpicking of several community and acute trusts in inner London in 1993 made any difference.

As far as I knew, community trusts were not directly involved in the LIZ programme review. I was only aware of it at the final drafting stage and saw the completed report by chance. As significant providers for primary care services, many community trusts would have wanted to address lessons about accessibility of primary care to vulnerable people outside the GMS model, workforce issues and so on.

The Turnberg report recognised some of the benefits community trusts can offer, despite the paucity of objective performance indicators. These benefits must be sustained before community trusts are prematurely written out of any more scripts.

Community trusts want to show they are not part of the problem, but part of the solution to the creation of primary care groups capable of sustaining levels 3, 4 and beyond, to deliver better and more equitable healthcare to Londoners.

Lucy Hadfield

Chief executive

Wandsworth Community Health trust