Polyclinics not the answer to improving care in London, says BMA
The British Medical Association (BMA) has warned that government proposals for healthcare service changes could result in damaging fragmentation and may not produce the predicted cost savings or improvements in patient care.
The setting up of polyclinics, a key component of Lord Darzi's plans for London, would require considerable "up front" investment in new buildings, equipment and staff, and it is difficult to see how they would be cost-effective, the BMA's response says.
The BMA argues that GPs with special interests and community hospitals already provide intermediate care services in premises outside of hospital.
Dr Hamish Meldrum, BMA Chairman, said: "Despite the government wishing to provide more care closer to home, it is likely that for most people in London, the polyclinic would actually be further away than their existing, local GP surgery.
"It would be much better to invest in existing GP services, and where necessary district general hospitals, rather than imposing costly, unproven polyclinics.
"The suggestion that private companies could run polyclinics would, in reality, destroy the UK model of general practice and threaten many district general hospitals. Both are respected throughout the world and are highly valued and trusted by patients."
The BMA's position is that such service changes must be based on good evidence and decisions made in partnership with clinicians in both primary and secondary care, and in consultation with the public, to ensure patients are seen in the appropriate locations by appropriately skilled and qualified clinicians.
Dr Meldrum added: "If the government is serious about engaging with clinicians, it must start listening to the views of London doctors and patients who have expressed many fears about how Lord Darzi's proposals would adversely affect patient care and potentially cost lives."
"It makes sense to improve existing services. At our practice we do 24-hour monitoring, stress tests, telelink to a vascular surgeon and on-the-spot BNP testing. Nurses run an acute illness clinic every weekday morning and one evening. The nurses work as an integrated team, ie, as practice and community nurses, which gives us great continuity of care at patients' home as well as at the surgery. And yet we are being critised by the PCT for being too expensive. Their words are we would love to copy your model of working but we would have to do it more cheaply! Top pay here is only band 6" - Heather Francis, Specialist Practitioner, Chorleywood, Herts