Lord Darzi’s London blueprint has been described as ‘pie in the sky’ after a three-month consultation.
Many people felt the health minister’s Healthcare for London: a framework for action report, published last July, contained good ideas but did not show how they would be achieved, the consultation reveals.
The outcome, published this week, states: “While there was significant support for the principles… many see these as idealistic and ‘pie in the sky’.”
The concerns come a fortnight after HSJ revealed NHS London’s misgivings over whether primary care trusts had the leadership capacity to carry out the work.
Healthcare for London suggested setting up polyclinics and centralising specialist services. Just over half of people supported the proposal that almost all London GP practices should be part of a polyclinic.
But others disagreed strongly, fearing polyclinics would be impersonal, involve extra travel and damage patients’ relationships with GPs.
A number of responses appeared to be prompted by local campaigns inviting patients to save their general practice from “privatisation”.
Healthcare for London project director David Sissling said: “Clearly there was anxiety about the more centralised model of polyclinics rather than the networked kind.
“It suggests that this will be an area [PCTs] will need to be particularly sensitive about.”
There was support for more outpatient care to be delivered outside of acute trusts and complex emergency services to be centralised.
However, the financial costs and effects on staff were questioned, with Barts and the London trust saying it did not feel the economic case for change had been made.
Its response expressed concerns “that a more distributed model of service provision might lead to a less effective use and potentially a dilution in skills unless adequate support, development and governance arrangements are in place”.
A draft report drawing together the consultation findings and pilot work undertaken will be sent to all PCTs in London and Surrey .
On 12 June, London’s joint committee of PCTs will discuss the report and how to take it forward.
For more analysis, see this week’s leader