King's Fund urges polyclinic caution
Primary care trusts should consider polyclinic models that do not centralise GP services under one roof, the King's Fund has urged.
The think tank recommends PCTs should consider "models which do not require mass centralisation of family doctor services", highlighting the hub and spoke model, where most GPs remain in their premises and draw on the resources of a central polyclinic.
Confusion has surrounded the concept, which first appeared in Lord Darzi's Framework for Action report for NHS London. The "GP-led health centres" proposed for all PCTs outside London by the health minister in Our NHS, Our Future were then assumed by many to be polyclinics by a different name.
The King's Fund focused its analysis on the pros and cons of "big building" polyclinics, where services are co-located.
It warns trusts should carefully assess the polyclinic approach and only proceed where it will clearly improve quality and access.
Candace Imison, co-author of Under One Roof, who is also director of strategy at Epsom and St Helier University Hospitals trust and visiting fellow at the King's Fund, said the model could offer great opportunities for more integrated care.
But she said benefits will only be realised "if the focus is on changing the way we deliver care", not just where care will be delivered.
This week's report came as senior health managers and academics expressed further concerns at a debate run by think tank Civitas.
Professor Martin Roland of the National Primary Care Research and Development Centre said there was a risk of an "expensive excursion" into new building without clarity over its purpose. "We must start looking at the system as a whole."
The King's Fund report is more critical than an NHS Confederation analysis of polyclinics in April, which called for a cautious and evidence-based roll-out but did not analyse the relative pros and cons of different models. At the time, NHS Confederation head of policy Nigel Edwards said "knee jerk reactions" against the clinics "seriously jeopardise progress for patients".
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