There are significant variations in the quality of primary care in London, according to a new report commissioned by NHS London from The King's Fund and Imperial College London.
The report highlights some examples of excellent performance - for example, some deprived parts of the capital have the highest rates of child immunisation in the country, and London practices have made good progress in adopting new information technology. But Londoners also report lower levels of satisfaction with GP services than patients elsewhere in the country - for example, they are less satisfied with access to services, the quality of consultations and support for managing long-term conditions.
In the coming years, London will face a growing health challenge as a result of an ageing population and unprecedented financial pressures. The report argues some practices in the capital are not equipped to meet this challenge.
While there has been investment in new facilities, some practices continue to operate from premises that are not fit for purpose.
Smaller practices tend to employ fewer practice staff. Almost 20 per cent of London practices are single-handed, compared with just 13.8 per cent across the rest of England. While this does not mean patients receive a poorer service it may limit what the practice can offer. The report argues that major changes are needed to the organisation and delivery of primary care to meet these challenges.
The report says GPs should work more closely with hospitals, community services and social care to improve the co-ordination of care, especially for patients with long-term conditions.
It adds that practices could move more quickly towards different models of service provision such as operating in federations or networks - this will enable smaller practices to retain their local focus but provide a wider range of services.
Anna Dixon, director of policy at The King's Fund, said:
'While there are some excellent general practices in London, the quality of care that Londoners receive is not as consistently good as it could be. There is huge potential to make better use of information and data to understand and address variations in performance. I hope this report will encourage GPs to engage in a discussion about how to lead a transformation in general practice to ensure all Londoners enjoy the best possible health care.'