Think tank: 'No evidence' to support polyclinics

Moving GPs into polyclinics could worsen access, increase costs and damage care, a King's Fund report has warned.

The report, ‘Under One Roof: Will Polyclinics deliver integrated care?', says there are ‘compelling arguments' for providing integrated health services closer to patients' homes.

But it warns that there is no evidence larger GP practices provide better services, and argues that ‘a major centralisation of primary care is unlikely to be beneficial to patients'.

The report calls for PCTs to abandon plans to concentrate GP services into fewer, larger sites. Instead they should pilot several models, such as hub-and-spoke and ‘virtual' polyclinics, it says.

Dr Niall Dickson, the King's Fund's chief executive, called for ministers to spell out ‘in unequivocal terms' that PCTs will not be forced to build the new centres.

The report examines examples of polyclinics abroad, as well as integrated health centres built under NHS Local Improvement Finance Trust (LIFT).

It argues that changes will not improve services without clinician support.
Other experts have echoed this suggestion that policy should focus on redesigning services, instead of just moving them to new buildings.

Professor Martin Roland, director of the National Primary Care Research and Development Centre, said at a Civitas event last week that polyclinics risked becoming an ‘expensive exercise in building new buildings without clear thought about what they would do'.

GPC chairman Dr Laurence Buckman welcomed the report. He said:  ‘It provides scientific, logical and international evidence that polyclinics probably won't deliver any of the things the government believes they will.'

But he added: ‘This government doesn't listen to evidence.'

A DoH spokesman said it was not government policy to impose polyclinics outside London. New GP-led healthcare centres are ‘about additional access and choice for everyone', he added.

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