Polyclinics Should Mean More Not Less, UK

Main Category: Primary Care / General Practice
Article Date: 21 Apr 2008 - 12:00 PDT

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The NHS Alliance, who represent frontline clinicians and managers in primary care, says that Polyclinics should enable the NHS to offer patients more services - and more locally.

That will only be possible with a flexible approach that is led by frontline clinicians, managers and patients. The Polyclinic model that many are discussing is likely to be successful in London and similar large cities, but would not be appropriate in other areas.

That does not mean ossification of existing services though. It makes sense to bring GP practices and other healthcare services together so that patients can benefit from integrated care and a greater range of services - some of which have been traditionally provided in hospitals. That is the basis of the Polyclinic concept.

For instance, College Surgery in Devon, where NHS Alliance chairman Dr Michael Dixon is a partner, has opened a new Integrated Centre for Health in Devon. Ten GPs are working at the same site with a wide range of health services, some PCT employed and some private Contrary to the notion that new services will mean closing small surgeries, the practice is keeping three branch surgeries in nearby villages - and all their patients will be able to access the full range of services when necessary.

The idea is to focus on wellness and maintaining health as well as treating illness. It has been four years in the planning - the practice was well in advance of proposals for Polyclinics.

Other alternative models might involve GP practices on several sites collaborating together and with other local services to provide a Virtual Polyclinic, or a number of small practices located at a single new site, perhaps with shared management services - the 'nested practice' concept put forward by the NHS Alliance and the Small Practices Association in 2005. Where the private sector provides some of the clinic's services, they should be partners. It is not intended that they should run them.

Dr Michael Dixon, NHS Alliance chairman, said:

"I know that many GPs and others have difficulty with the word "polyclinic" with its impersonal and biomedical connotations. But the concept of bringing practices together and providing a greater range of integrated services in the community has to be right.

"It might be true that small is beautiful, but professional isolation and poorly integrated services are not.

"Practices need increasingly to work with each other and with other partners in primary care, whether as virtual partners or on one site. There should not be a single template. All that matters is what is best for patients - and they and the frontline practitioners who look after them must be thoroughly involved and, wherever possible, leading any local plans."

Notes

1.The NHS Alliance is a collaboration of clinicians, managers and board members who put patients first. It is the independent body that represents NHS primary care. Values based, it is the only organisation that brings together PCTs with GP practices, clinicians with managers and Board members, and NHS primary care with its patients. The Alliance membership and its hard working national executive is fully multi-professional. It has twelve professional networks, including Providers Networks.

2.Proposals for Polyclinics are separate and different from a further Government initiative to improve GP access through the creation of 150 new GP-led health centres offering extended GP access.

3.The Polyclinic idea was behind a documented commissioned by policy advisers from NHS Alliance and the Small Practices Association in 2005. It suggested the formation of either purpose built premises - bringing practices together with other facilities on one site (called nested practices) - or virtual supersurgeries, linking local practices with extra services housed in the practices or more centrally.

NHS Alliance