Champion, challenge, collaborate

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 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 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.  

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)

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. 

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.  

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, calling for stronger action on health inequalities and structural racism, and for the final plans to set out more robust demand and capacity modelling for the future service.

In January 2025, the Mayor wrote to the NHS setting out his updated position on the final version of the proposals. The Mayor called for clear ambitions and measurable targets around tackling racial health inequalities and continued work with people with lived experience to co-produce and continually improve services.

The Mayor's response was informed by an independent review that he commissioned from the Strategy Unit.

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. 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. 

In March 2025, the Mayor wrote to the NHS setting out his updated position on final proposals. He called for the NHS to continue close engagement with community groups, monitor maternity and neonatal outcomes by ethnicity, and closely monitor future service demand and capacity.   

His letter was informed by the independent review he commissioned from the Nuffield Trust.  

In September 2023, NHS England launched a public consultation on future location proposals for very specialist cancer treatment services for children living in south London and much of south east England.

The Mayor submitted a consultation response in December 2023, calling for more information on impact the changes would have on other children’s services, and greater expected travel cost and patient time analysis.

In July 2024, the Mayor wrote to the NHS setting out his updated position on final proposals. He called for the NHS to set out clear plans and targets to reduce health inequalities the future services, as well as conducting ongoing engagement with patients and families. 

His letter was informed by the independent review he commissioned from the Strategy Unit.