Primary care trusts must act urgently to ensure the shake-up of services in the capital improves the welfare of vulnerable groups, the London Health Commission has warned.
The commission has completed a ground-breaking analysis of the impact on inequalities of reform plans in London. Its final report lists priorities and action points for the NHS in the capital.
It calls for guidance for PCTs to ensure polyclinics are easily accessible by public transport. It also calls on NHS London to establish outcome indicators for PCTs so they can monitor the health of disadvantaged groups. It also wants providers' to collect and evaluate equality data. And it suggests paying GPs to feed back data through the quality and outcomes framework system.
Vulnerable groups include carers, people with disabilities, ethnic minorities, low-income families and refugees and asylum seekers. Tackling health inequalities was a fundamental goal of the Healthcare for London proposals.
Earlier this year the commission warned proposed changes such as new polyclinics could worsen inequalities.
Commission co-ordinator Gail Findlay said the reforms were "an opportunity to target resources so the people who need healthcare the most get it and get good care".
One priority was investment in preventive services and health promotion "across all health pathways", she added. Polyclinics could have a positive impact if they were accessible, provided better care and were located in disadvantaged areas. "But if they're difficult to get to and mean removing existing services then they might not," she warned.
Robert Creighton, chief executive of Ealing PCT and chair of the London PCT chief executives' group, said cutting health inequalities was at the forefront of trusts' minds. "We would all say it is one of the absolutely essential outcomes of the changes," he said. "But one difficulty is evaluating the impact in the short-term." Trusts were looking at developing capacity to gather and analyse data on health needs, he added.
NHS London said it would officially recommend the report and its findings be accepted by PCTs.
"We are committed to making sure Healthcare for London does not increase health inequalities in London and further impact assessments will be commissioned as we move forward," said a spokesman.
The commission will be evaluating the impact of its assessment on local plans and hopes to report back by next spring.