Assessing the evidence on polyclinics

Under One Roof: Will polyclinics deliver integrated care?is a major piece of research into polyclinics in the UK and abroad. We wanted to find out if polyclinics really can deliver the changes the government wants to see for health care in England.

Our research began with a review of 93 operational NHS LIFT (local improvement finance trust) schemes. We found 12 that fitted the polyclinic model most closely – that is, big, community-based health centres, bringing together primary, community and secondary health care professionals under one roof. We carried out structured interviews with 28 people working in these 12 sites, including managerial and other staff, and visited three of the sites. We didn’t speak directly to patients but asked for feedback on their views during our interviews with staff.

The next stage of our work involved looking at the existing research relevant to the polyclinic idea. This included research on shifting services out of hospital and on the benefits and drawbacks of having larger GP practices.

We also looked at polyclinics abroad, including two facilities (the Polikum at Friednau in Berlin, and the Westchester Medical Centre in New York) that policy-makers in England cite as showing just what polyclinics can achieve. We considered some of the key differences in contexts between England, Germany and the United States – such as the structure of the workforce. This, and other factors, may have a significant bearing on whether the model can be transferred and still be put into practice successfully. 

Our report brings together the results of our research, assessing whether polyclinics really can deliver better, more accessible care, and bring down costs. Among its findings, the report shows that bringing staff together in one building doesn’t necessarily change the way they work or improve the service they provide.