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Gold, incentives and meh

PCTs go for polyclinics despite Darzi caution

By Steve Nowottny

PCTs across the country are pressing ahead with local plans for polyclinics – despite indications that Lord Darzi has gone cold on the idea.

Two-thirds of trusts contacted by Pulse this week said they already had or were planning new surgeries in line with the polyclinic model.

But NHS managers may have jumped the gun, with polyclinics, so central to Lord Darzi's Healthcare for London review, not featuring once in his 54-page interim report this week.

Lord Darzi said not all the recommendations of his London review – which advised the introduction of polyclinics – would apply elsewhere.

Instead his report calls for 150 GP-run health centres, focused primarily on walk-in services but also catering for registered patients.

Funded by new investment and situated in ‘easily accessible locations', the centres will provide extended opening and offer diagnostics.

But the Department of Health insisted the new centres were not polyclinics, and said they were more similar to improved walk-in centres.

A spokesperson explained the centres were intended to ‘bridge the gap between the idea that people can register in two places'.

But with polyclinics now firmly on the agenda, local PCTs appear to be embracing the concept. Three polyclinics are already up and running in East Lancashire PCT, with two more due to open in the New Year.

East Lancashire PCT said it was also waiting to hear back on bids to fund a further two polyclinics, each costing £10m.

Sheffield PCT said it was operating one polyclinic, Middlewood Primary Care Centre, with a second due to open ‘within the next few weeks'.

Elsewhere, PCTs said new developments would be expanded along polyclinic lines.

Six primary care centres planned in south-east Essex will house multiple practices and a range of other services, and a spokesperson for Hammersmith and Fulham PCT said that 25 GPs would be based in a long-planned development that was ‘pretty close to the polyclinic model'.

GPC chair Dr Laurence Buckman said PCTs were frantically rebranding existing projects in order to toe the Government line.

‘PCTs are sheep,' he said. ‘If the message comes out from the centre, call it a polyclinic, they'll call it a polyclinic.

‘It doesn't matter that it's still only two GPs and a chiropodist once a month – they'll still call it a polyclinic because they're scared stiff.'

When is a polyclinic not a polyclinic?

Undoubtedly this year's big idea, there is confusion over exactly what does and does not constitute a polyclinic.

The original model, proposed in Lord Darzi's Healthcare for London review, would hold up to 25 GPs serving about 50,000 patients.

Open 18 to 24 hours a day, the clinics would also house diagnostics and consultant specialists, and eventually handle up to 50% of outpatient treatment.

Despite some key similarities, the Department of Health denies the 150 GP-run health centres announced this week constitute polyclinics.

They will provide only a limited range of secondary services, and concentrate instead on providing consultations to commuters and others who find it hard to get to their GP.

But with PCTs developing a range of different primary care premises, the lines between polyclinics, supersurgeries and the traditional health centre are becoming increasingly blurred.

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