Think tank questions polyclinic plans
pharmafile | June 6, 2008 | News story | |Â Â Â
A government strategy to transform primary care in England has been dealt a blow by a respected think tank, which says there is no evidence to show it will improve patient care.
The independent and highly-respected King's Fund has issued a sceptical report on the plans for 150 polyclinics to replace traditional GP surgeries, adding its voice to opposition from frontline doctors.
The timing of the King's Fund report will be a source of acute embarrassment for government minister and NHS surgeon Lord Darzi, coming just days ahead of his much anticipated Next Stage review.
Chief executive of the King's Fund Niall Dickson has urged ministers not to make the polyclinic model compulsory.
He said: "Polyclinics may be the right answer in some areas, they will not be right for others. That should be a matter to be decided locally on a case-by-case basis using the best clinical evidence available together with a full assessment of the costs and the impact on patient access."
The introduction of polyclinics across England is a key aspect to Darzi's interim report for the NHS Next Stage Review, which has promised to improve care by bringing the services of an area together to a single patient facility.
The redesign aims to improve patient choice, cut hospital admissions and save money, according to government, but opponents say it will undermine the tradition of the NHS by leading to the closure of GP practices and other established services.
The King's Fund is the latest of many stakeholders to critique the plan, and has warned that polyclinics are not a universal solution to problems in the NHS.
It researched the current and limited development of polyclinics both in the UK and abroad to give key findings on cost, accessibility of services and quality of care.
It found while polyclinics could bring some benefit to some patients, there was no real evidence to say they will universally improve quality of care and accessibility of services in the NHS.
Conversely, the report says in practice opportunities are often lost in bringing together multiple services together, and there is no proof that larger GP practices deliver higher quality care than smaller ones.
It also said the moving of services does not guarantee greater efficiency, and the cost of redesign could outweigh the marginal benefit in some areas.
The report's co-author Candace Imison stressed that polyclinics are not a one-fits all solution.
She said: "For some health communities the development of polyclinic-type facilities could offer great opportunities to establish more integrated care that delivers real benefits to patients. But these benefits will only be realised if the focus is on changing the way we deliver care, not just changing where care is delivered."
The strength of opposition to polyclinics could see the government back down from forcing areas to adopt the polyclinic model, potentially adding further instability to a system still recovering from successive reorganisations.
