NHS managers call for calm in debate on polyclinics

BMJ 2008; 336 doi: (Published 24 April 2008) Cite this as: BMJ 2008;336:911
  1. Rob Finch
  1. 1London

The NHS Confederation last week called on interested parties to keep calm and consider the evidence when evaluating the proposal for polyclinics made by the health minister Ara Darzi last summer (BMJ 2007;335:61; doi: 10.1136/bmj.39273.467697.DB).

Its report was attacked by opposition politicians for “missing the point” and was criticised by senior GPs.

The confederation’s anonymous report blames “misconceptions” about polyclinics for impeding the consideration of their benefits. Far from disrupting continuity of care or undermining general practice, it says, polyclinics can improve access as well as allow patients to see their own doctor.

The confederation also says that polyclinics are not appropriate in every area and that there need be “no national blueprint for how polyclinics should work.”

Nigel Edwards, director of policy at the NHS Confederation, lambasted opponents of polyclinics, saying that “knee jerk reactions” based on “pre-existing agendas” could jeopardise future patients’ outcomes.

He said, “We have been genuinely surprised to see the level of concern surrounding these proposals among the health community and patients’ groups. What we need now is a calm and balanced debate about how to bring out the best in our primary care services.

“Of course this is not something that will work in every circumstance, but delivering better organised care focused on the patient is surely a good thing.”

But the confederation’s request was dismissed by the Conservative shadow health secretary, Andrew Lansley, who accused it of “missing the point.” He said, “If the NHS Confederation want to take the heat out of this then they need to persuade the government to shelve their plan for imposing polyclinics.”

The Liberal Democrat shadow health secretary, Norman Lamb, was similarly unmoved, because of the government’s apparent “dishonesty” about having asked all primary care trusts to open at least one polyclinic “in the near future,” before consultation is complete.

The confederation’s report stoked yet more reaction from GPs’ leaders. Laurence Buckman, chairman of the BMA’s General Practitioners Committee, said, “We are against the headlong rush into polyclinics or health centres that is a current feature of primary care trust [PCT] activity all over the country.

“Rather than being forced to create new services in this way, PCTs should be encouraged to invest in their local general practices and support joint working between practices.

“This would deliver the goals of the Darzi review without the risk of unnecessarily duplicating or destabilising existing services, and would undoubtedly be better value for money for the taxpayer.”

Steve Field, chairman of the Royal College of General Practitioners, said that the college “is not opposed to polyclinics per se and acknowledges that they could work well in certain areas of the country.

“Our main criticism is the emphasis on continuity of information rather than continuity of care, which is one of the core values of general practice.” See Feature doi: 10.1136/bmj.39552.381053.DB.

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