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The London Sexual Health Transformation Programme (LSHTP) is a partnership of 32 London Boroughs working to deliver a new collaborative commissioning model for open access sexual health services. The programme has facilitated cross London joint working to set up new services, agree new pricing mechanisms and ensure coordinated expert clinical specifications for all services, producing better outcomes for patients and better value for commissioners.To deliver this transformation the programme set up three distinct work streams: developing a new pan London e-services model for sexual health to better signpost patients to the right services and provide home testing kits where clinically justified; developing a new pricing mechanism that supports flexibility and planning; and supporting sub regional groups to re commission face to face services with a new agreed clinical specification to support overall system transformation objectives.Transformed services; a new online offering, and a new London wide clinically agreed service specification. Improved resident access and experience. Patients will no longer need to attend a clinic if they don’t wish to but will access expert advice, triage and testing in their home or safe space elsewhere. Saved approximately £30 – 40m through collaborative commissioning and patient channel shift away from expensive clinic attendance where it is not needed Built and maintained partnerships across London. It has been a major achievement to construct and sustain a collaborative of 32 London boroughs involved in this programme.Is collaboration the way forward for effective commissioning?