Champion, challenge, collaborate
The Mayor plays an important leadership role in shaping a city that promotes good health for all Londoners. He brings together partners to protect and improve the health of the city. Although he is not responsible for health and care service delivery, the Mayor champions, challenges and collaborates with the NHS and other health partners on behalf of Londoners.
The Mayor:
- Champions and campaigns on health issues that are important to Londoners.
- Collaborates with NHS and London boroughs on issues to improve the health of Londoners.
- Creates new health and social care academies and leverages London’s health and care anchor institutions, to support the workforce in health and social care.
- Fights for the funding the health and care service needs, and champions the work of those who deliver these services.
- Works with partners to support a high quality health and care system for all Londoners - and he chairs the London Health Board.
- Works with charities and the NHS to maximise the number of public access defibrillators.
- Meets regularly with senior leaders in NHS London, including the London Ambulance Service.
- Challenges NHS organisations to deliver the health and care services Londoners need and deserve.
- Applies the Mayor’s six tests to any major change to NHS service provision in London, to ensure that changes are in Londoners’ best interests.
Our health and care partners
The London Health Board (LHB) is a non-statutory group chaired by the Mayor and made up of elected leaders and key London professional health leads. The Board meets three times a year to explore issues that affect the health and wellbeing of Londoners and work together to tackle pan-London issues, champion good practice and challenge London’s health and care leadership to drive improvements.
The London Vision for Health and Care is a partnership between the Greater London Authority, UK Health Security Agency, Office for Health Improvement and Disparities, London Councils and the NHS in London. Under the vision, partners have committed to work together towards making London the healthiest global city.
The Mayor's Six Tests
The Mayor recognises how important it is for Londoners to be able to have their voices heard, especially their views on changes to the hospitals and health services they use.
The Mayor’s six tests are six conditions that must be met before the Mayor will support any major health and care transformation or service reconfiguration in London, to ensure that the changes are in the best interests of Londoners.
The Mayor's six tests were developed in 2017 following publication of the King's Fund/Nuffield Trust report into London's five sustainability and transformation plans (STPs).
The Mayor will apply his six tests to major service reconfiguration programmes – where significant changes are proposed and/or where large populations across multiple boroughs are likely to be affected.
The first four tests will be applied at the point proposals are put out for formal public consultation. The application of the final two tests will be carried out after the period of public consultation.
The Mayor will apply a series of supplementary questions to help him review major proposals. These will act as a guide, and not all will be relevant in every case.
The Mayor's Six Tests Refresh
The COVID-19 pandemic had a disproportionate impact on Londoners and widened health inequalities across London. The Mayor wants to reflect this in his six tests. He commissioned the Nuffield Trust to take an in-depth look at the ways in which the health inequalities test, could be strengthened.
The Mayor has written to the NHS to explain how he is updating his six tests in response to the report from the Nuffield Trust.
The Mayor has also updated the hospital beds test. The Mayor has made these changes to ensure that London’s healthcare facilities are built to an excellent standard with the best quality care, and hospitals and care facilities are equipped to deal with large scale health emergencies.
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Demonstrate that sufficient alternative provision is being put in place alongside or ahead of the proposed changes, and that the additional workforce required will be there to deliver it.
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Show that specific new treatments and therapies will reduce specific categories of admissions.
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Show, where a hospital has been using beds less efficiently than the national average, that the hospital has a credible plan to improve performance without affecting patient care.
Read about when the Mayor has applied his six tests to major service reconfigurations in London
Moorfields Eye Hospital: Project Oriel (February 2020)
Epsom and St Helier: Improving Healthcare Together (July 2020)
North Central London Adult Elective Orthopaedics Service Review (September 2020)
London’s Integrated Care Systems: Five-year plans (February 2021)
Following the publication of the NHS Long Term Plan in January 2019, local Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICS) were asked to develop five-year strategic plans setting out how they would deliver the national commitments.
The Mayor commissioned the King’s Fund to review the development of STP/ICS plans and priorities within London, taking into account the principles of the Mayor’s six tests.
The report shows how the demands of the pandemic led to organisations across the health and care sector working closer together. It highlighted the devastating impacts of the pandemic on London’s diverse communities but also the work planned to tackle the resulting health inequalities.
North West London Integrated Care System: Proposed elective orthopaedic care centre (January 2023)
In November 2022, North West London Integrated Care System (NWL ICS) set out proposals to create an elective orthopaedic centre at Central Middlesex Hospital. Under the proposals, all north west London elective orthopaedic inpatients requiring ‘low complexity’ surgery would receive their operation at this centre.
The Mayor responded to a public consultation on the proposals in January 2023. His response was broadly supportive of the proposals, but called for more robust action on health inequalities and a more detailed workforce plan.
In March 2023, the final plans and a public consultation report were published by NWL ICS. The Mayor followed this up with a new response, which remained broadly supportive and welcomed progress made on health inequalities, social care and public engagement. He also outlined further action for NWL ICS to consider, including ongoing engagement with local authorities and steps to ensure that elective orthopaedic care is accessible to all.
The Mayor’s response was informed by an independent review that he commissioned from the Nuffield Trust.
Very specialist children’s cancer treatment services in South London (December 2023)
In September 2023, NHS England London and NHS England South East launched a public consultation on proposals for the future location of very specialist cancer treatment services for children living in south London and much of south east England.
The Mayor submitted a response to the consultation in December 2023. His response was informed by an independent review that he commissioned from the Strategy Unit.
In his response, the Mayor called for further analysis to be done on inequalities in the current service, as well as for specific plans and targets for reducing inequalities through the future service. He also called for more information on the impact that the changes will have on other children’s services and on the benefits the changes will bring for patients and their families.
The Mayor will write an updated response to the proposals once the final plans are published.
Future of acute adult mental health services in North West London (January 2024)
In October 2023, North West London Integrated Care System launched a public consultation on proposals for the future of acute mental health services for adults aged 18-65 years old in the City of Westminster and the Royal Borough of Kensington and Chelsea
The Mayor submitted a response to the consultation in January 2024. His response was informed by an independent review that he commissioned from the Strategy Unit.
In his response, the Mayor called for analysis of the reasons behind inequalities in the current service and for specific plans for reducing those inequalities through the proposed future services. He also called for the final plans to directly address structural racism and to set out more robust demand and capacity modelling for the future service.
The Mayor will write an updated response to the proposals once the final plans are published.
Future of maternity and neonatal services in North Central London (March 2024)
In December 2023, North Central London Integrated Care System launched a public consultation on proposals for the future of maternity and neonatal services in North Central London.
The Mayor submitted a response to the consultation in March 2024. His response was informed by an independent review that he commissioned from the Nuffield Trust.
In his response, the Mayor called for clear plans and targets for how the changes will reduce health inequalities, additional modelling to ensure that there is sufficient resource in North West London to appropriately cater for changed patient flows, and further work to understand and address any impacts the changes might have on wider hospital services.
The Mayor will write an updated response to the proposals once the final plans are published.