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NHS managers question viability of polysystems rollout

By Ian Quinn

Exclusive: NHS managers have raised serious doubts about the viability of controversial plans to group GPs in polysystems and transfer hundreds of thousands of hospital cases to them.

Documents uncovered by Pulse demonstrate concerns within at least one PCT that some of the so-called polysystems being launched by NHS London could end up costing more money than they save.

The revelation comes with the BMA urging GPs to attend a rally at its headquarters on 25 February – where GPC chair Dr Laurence Buckman will be one of the key speakers – as it spearheads the battle against the ‘unproven’ polysystems model.

A report reveals NHS Westminster, meeting two days before NHS London unveiled plans for more than 100 polyclinics across the capital, claimed the policy of having groups of GPs practices serving up to 80,000 patients, based around major ‘hub’ buildings, was not practical in large areas.

Areas including Paddington, Queens Park and the northern half of central London do not have ‘sufficiently sized premises’, it said.

The report also raises fears over the affordability of the polysystems proposals.

‘A key principle in designing each polysystem is that it costs less than the existing service and delivers savings,’ it adds.

‘This requirement has a fundamental impact on the feasibility of delivering certain elements… It will be essential sufficient activity and funding can be diverted from A&E to the new service to make it financially viable,’ says the report, adding: ‘This may not be achievable in certain parts of the PCT.’

The report claims there is also a danger of polyclinic buildings threatening each other’s viability.

Neighbouring Kensington and Chelsea PCT is developing a major polysystem hub at St Charles Hospital, which Westminster claims means its cross-border plans ‘would not make sense from a service or economic perspective’.

The development of polyclinics in London has been fraught with controversy, with the economic crisis forcing a massive scaling back of the original plans put forward by Lord Darzi and now fears growing over the viability of the hub-and-spoke model.

A report by NHS Hillingdon reveals the evidence for its polyclinics strategy was branded as ‘weak’ by NHS London itself, which said it lacked evidence of affordability and how GP practices would work together, as well as ‘justification’ of the chosen sites.

The polyclinics rollout may cost more than it saves, NHS managers fear The polyclinics rollout may cost more than it saves, NHS managers fear