Feature Integrated Care

Are Darzi-style clinics set to make a comeback?

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f343 (Published 21 January 2013) Cite this as: BMJ 2013;346:f343
  1. Gareth Iacobucci, news reporter
  1. 1 BMJ, London WC1H 9 JR, UK
  1. giacobucci{at}bmj.com

They were white elephants of the noughties, but Gareth Iacobucci reports how a new incarnation of the polyclinic could help GPs deliver the NHS reform agenda

In 2008, polyclinic was a buzzword in the NHS. The concept of large modern buildings housing general practitioners alongside specialist services gained traction when surgeon turned Labour health minister Ara Darzi identified them as a key mechanism for reshaping primary care in his report on new ways to deliver healthcare in London.1

The proposals brought vocal opposition from the BMA, which campaigned against polyclinics 2 amid fears they could threaten traditional general practice by encouraging private sector providers to run new centres. But Darzi’s vision was soon extended to the whole of England when his NHS Next Stage Review3 ordered 150 new polyclinics, which soon became known as “Darzi centres.”

Designed to improve access to primary care while reducing reliance on hospitals, the centres were envisaged as “one-stop shops” for both registered and walk-in patients.

But polyclinics proved costly white elephants, with many closed in subsequent years after failing to deliver value for money.4 In some cases, the number of walk-in patients far exceeded expectations without reducing pressure elsewhere in the system, and the coalition government subsequently asked primary care trusts to consider decommissioning contracts.5

The term polyclinic was quickly abandoned in NHS circles after this unsuccessful venture. But although the term is dead, new developments suggest the concept is re-emerging.

Reincarnation

The Frome Medical Centre, a new £10.5m (€12.9m; $16.9m) health complex in Somerset, opened this month to much local fanfare, with the promise of providing easily accessible primary and secondary care to more than 30 000 patients.

The project was conceived in 2001, some seven or eight years before Darzi’s plan, but has only now come to fruition after five …

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