Healthcare for London’s A Framework for Action offers radical solutions to the problems that the health minister Ara Darzi has identified.1 Although only part of a very comprehensive review, the polyclinic has grabbed the headlines.

Three types of polyclinic are described in the consultation document Consulting the Capital, each serving a population of 50 000 patients.2 The networked polyclinic is essentially the current model, where a group of practices, as part of a locality cluster or a practice based commissioning group, share referral protocols and care pathways into secondary care, and a wide range of community based enhanced services. Same site polyclinics bring together practices under one roof to share access to an extended range of services.

The third model, and most controversial, is the hospital polyclinic. The hospital polyclinic is the preferred model of NHS London (London’s strategic health authority). NHS …