NHS London is deferring work on health inequalities to focus on improving commissioning and delivering Lord Darzi's vision.

Instead, the strategic health authority will focus on "working with and influencing PCTs and public health teams" to deliver its inequality goals.

The shift in focus comes as NHS London faces criticism for prioritising finance over service quality.

A business plan discussed at last week's board meeting states: "We are a small organisation and cannot take on significant new projects in 2008-09 without impacting on our ability to deliver the 2008-09 activities set out in the strategic plan."

Six priorities

Short term performance will be prioritised over long term goals, it says. Six priorities are named in the plan, including health minister Lord Darzi's Healthcare for London blueprint published last July, commissioning, and improving internal organisation.

Four areas are listed as "activities that could be deferred to future years or delegated to others without having a significant impact".

These are reducing health inequalities, developing productivity indicators, maximising benefits from research and innovation, and implementing a corporate social responsibility strategy.

A spokesman denied the move meant the SHA would be stopping work on health inequalities. He said: "PCTs are the best placed health organisations to judge what needs to be done in their areas to improve the health of their citizens."

Reducing inequalities

Faculty of Public Health president Alan Maryon-Davis said: "I think SHAs have a fundamental role in overseeing the reduction in health inequalities in public services. Health inequalities are a massive issue in London." He said he hoped the problem would be addressed in the SHA's Healthy London programme, which looks at issues such as smoking and life expectancy.

London was also discussed at a Healthcare Commission meeting last week, where it was revealed that recent annual health check inspections had found little improvement in many trusts' ability to demonstrate compliance with core standards. Commissioner Jennifer Dixon asked what NHS London was doing about the fact that "the quality of service scores haven't really changed year on year".

London and South East region head Sampana Banga said she thought "the balance of priorities over the last three years has swayed towards those of finance".

Commission chief executive Anna Walker said the small size of London PCTs was partly to blame. Quality of care also varied considerably between the centre of London and its outskirts. The Commission plans to discuss this with NHS London chief executive Ruth Carnall on Monday, she said.