Primary care trusts in the capital are being told to push on with plans to introduce the ‘full range’ of poly-clinic models envisaged by Lord Darzi in the face of heavy criticism.
A draft NHS London report, to be sent this week to London’s 31 PCTs and Surrey PCT, calls for polyclinic pilots to be set up despite British Medical Association and Conservative Party opposition. The report represents NHS London’s final decision on which proposals in health minister Lord Darzi’s Healthcare for London report, published last July, it wishes to take forward.
The report proposed placing GPs and other such as dentistry and diagnostics within a community health facility - known as a polyclinic.
The types of polyclinic proposed in the report are a “federated” model, where GP practices would share common services, a “co-located” model with multiple practices sharing services, and a vision in which GP practices would combine into one large practice.
Just over half of people consulted supported polyclinics, but many disagreed strongly, fearing they would damage patients’ relationships with GPs and force them to travel long distances.
Healthcare for London project director David Sissling told HSJ he wanted to see “more outpatient care in the community in integrated care provision arrangements”.
It would be up to individual PCTs to decide which polyclinic model was best for their local populations, Mr Sissling said.
But asked whether it would be acceptable to NHS London if no PCTs accepted one of the proposed models he said: “No. We want to make sure we get the full range.”
Pressed on how such decisions would be reached, he said: “It’s not about exerting pressure [on PCTs]. The issue is about services and we want to make sure we get the right kind of service provision.”
The report recommends that specialist centres for stroke and trauma patients proposed in the initial Darzi report should go ahead, although it will be down to PCTs to decide on the exact number and locations.
It does not address how the changes would save£1.4bn a year, the figure given in Lord Darzi’s original proposal, but Mr Sissling said PCTs would have to provide detailed cost plans for any resources they invest.
PCTs will begin to consider the proposals next week before the joint committee of PCTs meets in public next month to discuss how to act on the draft report.