Polyclinics

 

The issue of polyclinics has been in the spotlight recently, and has attracted a degree of controversy. The proposals have been welcomed by some professionals, whilst for others they have provoked concern and criticism.

 

In July 2007 Lord Darzi was commissioned to lead a review of the NHS and to propose changes to bring healthcare in line with the needs of patients in the 21^st century. In his interim report, published in October 2007, the plans for the introduction of polyclinics were outlined. For more information on polyclinics, please click here.

 

The Patients Association is concerned that the polyclinic proposals are in danger of jeopardizing the patient-doctor relationship; a central plank of effective and personalized care. Patients have had 60 years of knowing that their GP is also their gatekeeper to the rest of the NHS. This relationship has been central to every patient’s experience of healthcare. Where it works well, patients will fight to keep something important to them. The clinical benefit of such continuity cannot be underestimated as well, especially for patients with long-term or complex conditions.

 

Patients also want to have their healthcare under one roof. The “one stop shop” is something taken for granted in other parts of their daily life. In the past it has not happened in the NHS because of the independent status of GPs, dentists and others who contract with the NHS. That hurdle has been overcome with great success to create one stop shops, which are of particular benefit to those with mobility difficulties and carers.

 

The deep concern many patients have is that polyclinics may offer a one stop shop – on a vast scale – but not the continuity of clinician they value. Not seeing the same GP twice is an increasing complaint of patients who are de-personalized by such a system. Gathering under one large roof so many health services may work in cities but in rural areas it may actually put patients at risk. Rural patients are already disadvantaged in relation to travel times to acute care and rely heavily on primary services.

 

Polyclinics are not the same as one stop shops or health centres and it is unrealistic to expect them to work in rural areas without loss of other health services. Before we rearrange the estate and facilities of the NHS in such a radical way, we need to know it will work in the way patients want, with patients at the centre of the NHS.