'Darzi argues that his approach to this study - listening to Londoners, building a clinical consensus, providing evidence for the recommendations, working with the mayor and London boroughs - provides the foundations for success'

Professor Sir Ara Darzi's review of services in London gives us clues as to how he will lead the national review announced last week (see 'Sir Ara sets out London vision for cradle-to-grave healthcare').

The opening paragraphs condemn poor patient safety and health inequalities. Then the junior minister admits there has been a long line of reports into London's healthcare, many of which have made little difference. He argues that his approach to this study - listening to Londoners, building a clinical consensus, providing evidence for the recommendations, working with the mayor and London boroughs - provides the foundations for success.

His proposals are radical, with polyclinics proposed as the hub of primary care and the plans specifically tailored to London's needs. There is no hint here of some idealised academic blueprint; instead the review looks at everyday challenges such as transport links.

But Sir Ara also highlights the need for investment and quick wins to secure public support for service changes. In a city with some of the best and worst outcomes in the country, tangible improvements in access and quality will be the touchstones of success.