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GPs buried under trusts' workload dump

GP alarm as NHS managers push for paediatric centres in polyclinics

By Ian Quinn

NHS managers are to establish a series of primary care ‘children's centres', based in polyclinics, to spearhead the transfer of paediatric care from hospitals.

The move looks to put into practice hugely controversial commissioning guidelines laid out by Healthcare for London last year, which many fear would strip GPs of their lead role in paediatric care.

NHS East of England, NHS South East Coast and NHS Yorkshire and the Humber have also developed plans to create community paediatric practitioners and move child outpatient work out of hospitals.

But Pulse has learned GP experts in child health are furious the latest plans have been developed without consulting local practices.

NHS North Central London Strategic Health Authority aims to co-locate children's centres in polyclinics as part of plans to move a huge volume of workload out of hospitals.

The authority, including Barnet, Enfield, Haringey, Camden and Islington, has set out plans to ‘shift of up to 40% of outpatient work to the community settings' and for ‘consolidation and co-location' of child services into polyclinic hubs, serving local polysystems, led by ‘specialist paediatric staff'.

But GPs on the ground, even those who practices have been earmarked as possible polyclinic hubs, told Pulse they had been left completely in the dark.

Dr Stephen Amiel, a GP in Camden who with his partner, RCGP president Dr Iona Health, published the book Family Violence in Primary Care, said: ‘As someone with a long track record in child healthcare I ought to know more about these plans than most and I know nothing.

‘Camden GPs have only just been called for a meeting with the PCT. I'm speaking as a potential hub practice yet I could write down what I know about polysystems on the back of an envelope.'

The Healthcare for London report claimed services needed to be revamped partly because of the poor training of GPs, claiming 40% had no training in paediatric medicine.

But Dr Amiel, who has served on Camden's child protection committee, said he was strongly opposed to the plans, claiming they could damage the generalist role: ‘I have long argued in favour of a multi-agency approach, but my worry is it's being done to cut costs.'

Dr Paddy Glackin, secretary of Camden and Islington LMC, said: ‘One of the great strengths of general practice is the holistic care we provide. I don't believe there is any evidence we aren't doing a good job.'

NHS managers are to establish a network of children's centres Children's GP plans

• Shift of up to 40% of out patient departments to the community settings
• Urgent care services for children to be integrated with primary care
• Consolidation and co-location of services from a community hub (polysystem or children's centre)
• Community based multi-disciplinary teams to provide care for children led by specialist paediatric staff
• Increased coordination and knowledge sharing between secondary and community based paediatric services
• Paediatric assessment units (PAU) at every A&E dept staffed by specialist paediatric staff

Source: NHS North Central London Strategic Health Authority strategy plan

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