Radical revamp of NHS in London proposed
pharmafile | July 13, 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 procedures.
Health Minister Professor Sir Ara Darzi led the review of healthcare services in London, but his proposals have not generally been well received.
The Prime Minster was forced to deny they would lead to hospital closures and doctors leaders warned polyclinics – combinations of GP surgeries and a variety of other services – may not be in patients' best interests.
Prof Darzi's report concluded 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," he said.
Although Londons health service performs well by some measures, such as coronary heart disease mortality rates, it also faces a number of challenges.
The capital has 57% of Englands cases of HIV, is home to one in four adult drug users and one million Londoners have had mental health problems.
Doctors leaders agreed that changes to Londons 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 and the NHS Confederation, which represents more than 90% of NHS organisations, hailed it as "a vision which will revolutionise care in London".
Confederation 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 wants his proposed changes to help London stay at the cutting edge of health research.
To achieve this he suggests 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 offered 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.
