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Polyclinics: your questions answered

What is a polyclinic, how many are there, where are they and how are they being funded? The big questions on polyclinics answered.

What exactly is a polyclinic?

Confusingly, there is no one definition, and even the idea's strongest advocates admit exact specifications vary (see left). But essentially polyclinics are GP health centres which are substantially larger than traditional surgeries, open longer and house a range of additional services.

What are the different models of polyclinics?

Several different models are proposed. The ‘merged' model, which would see a number of GP practices moved under one roof, together with diagnostic and outpatient services, has inevitably attracted most comment, with many GPs arguing the model will depersonalise patient care.

The ‘federated' or ‘networked' model would see existing ‘spoke' practices linked to a local ‘hub' with specialist services.

How many are being built and where?

In London, up to 150 polyclinics are planned over the next 10 years, with the first 10 pilots due to be up and running by April 2009. The Government also plans 152 GP-led health centres – now being termed polyclinics – across the UK.

Each PCT will have one, regardless of need, with deals to be signed by December 2008. PCTs are also developing their own initiatives on an individual basis.

For example a pioneering polyclinic which includes complementary therapies opened in Cullompton, Devon earlier this month.

Do polyclinics exist already in England?

Right now, if it's large, shiny and open on a Saturday morning, chances are someone's calling it a polyclinic. PCTs are rushing to rebrand whatever they can with the latest buzzword.

But judged according to Lord Darzi's original model there are still very few in the UK, although Hounslow and Brighton both boast possible contenders.

And overseas? What does the evidence show?

Overseas, polyclinics can be found in Eastern Europe, Cuba, Germany and the Far East, among others. But evidence on their value remains inconclusive – in fact, a major criticism of the plans overall is that they lack a reliable evidence base.

Where is the money coming from?

Nationally, the Darzi polyclinics will be funded from £120 million of the Government's £250 million access fund. In London, the plan will be PCT-led. But experts have warned that the London plans rely on ‘unsafe' projections that polyclinics will save £1.5 bn over traditional general practice.

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