Polyclinics 'may not boost care'

Ministers want 150 new "polyclinics" in England, offering GP appointments as well as treatments and tests normally available only in hospital.

The King's Fund said patients outside cities could end up travelling longer distances for no improvement in care.

The Department of Health insisted existing centres would not be replaced.

The GP-led health centres are part of government plans to make it easier for people to see a GP and have simple tests and treatments carried out without having to go to hospital.

However, they have sparked controversy from the start, with some doctors suggesting that smaller surgeries might be at risk of closure as patients were drawn away to a new facility.

While the King's Fund said that there were opportunities for the new system to improve care, there were also risks.

'Varying impact'

Chief executive Niall Dickson said: "For some patients, access to diagnostic tests and other services, such as minor surgery, would improve under polyclinics but the impact would vary depending on how large and centralised the polyclinic would be.

"A major centralisation of GP services into polyclinics would make it more difficult for patients to visit to their GP, especially those living in rural areas.

"This would be a major sacrifice given that primary care visits account for 90% of all patient contact with the NHS, and that patients are less prepared to travel further to see their family doctor than they are to use outpatient and hospital services."

The report added that just bringing together higher numbers of GPs in the same building was no guarantee that they worked together more cost-effectively and to the advantage of patient care.

"The evidence suggests that, in practice, these opportunities are often lost - bringing together multiple services does not always result in better working practices between professionals, and there is no evidence that larger GP practices deliver higher quality care than smaller ones."

'One size fits all'

Nigel Edwards, the chief executive of the NHS Confederation, also warned the government not to be too hasty in rolling out the new clinics.

"While polyclinics could deliver significant benefits for patients, it is crucial that a 'one size fits all' model is not imposed on a national level.

"It would be a mistake to assume polyclinics can always save money by moving care out of hospital, but rather we should focus on how they can allow the NHS to work in a more organised and effective way.

"Polyclinics are not just big new buildings, and centralisation of services would not work in every area, especially rural areas."

The British Medical Association's annual consultant conference, held this week, voted to support a motion describing the proposals as "unproven, crude and expensive", and called for the introduction of polyclinics to be studied in pilot form before wide-scale introduction.

The Department of Health, however, suggested the new centres were no threat to existing GP surgeries.

"We are not imposing super surgeries, or polyclinics, or replacing existing services.

"In fact, we are investing record sums in existing GP practices as well as providing more GP practices in under-served areas.

"The 150 GP-led health centres, which will be established across the country, will complement existing GP practices and serve as an extra way to see a doctor.

"This is about additional access and extra choice for everyone."

Source : BBC Health News