This is a report of a survey undertaken on behalf of the King's Fund London Commission. It provides an overview of the current configuration of acute hospital services in London, and consists of a description of the method and data sources used for the survey, a profile of acute services within London, a pan-London view of specialties and their distribution across trusts, and an examination of how hospital configurations have changed in recent years, how they are expected to change in the future, and the reasons for change as reported by London planners participating in the survey.