Is London’s revamp a taste of things to come for the NHS?
pharmafile | August 15, 2007 | News story | |Â Â Â
A review of the NHS in London has recommended setting up a network of 150 polyclinics to take on much of the work currently done by hospitals.
The radical reorganisation would then give local hospitals the bulk of routine work, freeing major acute hospitals to undertake complex and specialist work.
Health Minister Professor Sir Ara Darzi led the review of healthcare services in London, but his proposals have not been well received.
The Prime Minster was forced to deny they would lead to hospital closures and doctors leaders warned that polyclinics – combinations of GP surgeries and a variety of other services – may not be in patients' best interests.
Prof Darzi said there was a compelling case for change and that polyclinics would best fill the gap that currently exists between primary care and hospital care.
"Most GPs provide an excellent and well-regarded service, but they do not have the facilities to undertake even quite simple diagnostics on site, which means patients face multiple trips to hospital for quite straightforward procedures," Professor Darzi said.
Although London's health service performs well by some measures, such as coronary heart disease mortality rates, it also faces a number of specific health challenges. The capital has 57% of England's cases of HIV, is home to one in four adult drug users in England, smoking is more prevalent than nationally and one million Londoners have had mental health problems.
Doctors' leaders agreed that changes to London's health services were long overdue, but said polyclinics could destabilise and fragment existing hospital and GP services.
Chairman of the BMA's London Regional Council Dr Tiz North said: "It seems odd to invent a new model for healthcare when there is already a successful and proven system of general practice which is highly-rated and trusted by patients.
If the proposals are adopted, polyclinics could provide up to half of all hospital outpatient treatment by 2017."
Darzi's report did find favour with healthcare managers with the NHS Confederation, which represents more than 90% of NHS organisations and hailed it "a vision which will revolutionise care in London".
Chief executive, Dr Gill Morgan said: "There are real challenges for the delivery of healthcare in a large and complex city like London and these plans give the opportunity for care in London to leapfrog to the best in England."
Darzi also said the changes would help London stay at the cutting edge of health research." Half of the UK's biomedical research is carried out in the capital, but the country risks lagging behind its international competitors," he said.
He proposes establishing academic health research centres, where research, clinical services, education and training can be combined to help ensure research breakthroughs directly benefit patients.
There are already such centres in cities like Toronto and Boston, and Darzi said the recent announcement of three comprehensive and four specialist biomedical research centres in London offers the first step in doing this.
Although the report focuses solely on London, Professor Darzi has also been placed in charge of a fundamental review of the NHS across England, which is due to be published next July.
