Assessing the evidence on polyclinics

Government proposals to develop ‘polyclinics’, or GP-led health centres, have generated much controversy. The government has argued that these centres will offer local communities convenient access not only to primary care services but also to a much broader range of health services. Opponents of polyclinics worry that they will threaten local GP services and undermine the personal relationship between GP and patient.

The term ‘polyclinic’ is a loose one that can be applied to a variety of different health facilities, including many that already exist in England. The GP-led health centres currently being developed across the country can be considered to be examples of the polyclinic model, as can other existing facilities going under various names such as super-surgeries or community hospitals. In some cases, the services are not literally brought together under one roof, but are integrated into a ‘virtual’ polyclinic.

Policy-makers in England have been impressed by the apparent success of polyclinics elsewhere, often citing the achievements of the Polikum at Friednau in Berlin, and the Westchester Medical Centre in New York. Several other countries have recently taken a strong interest in the polyclinic model, including Germany, Northern Ireland and Canada.

The King’s Fund has looked at the evidence on polyclinics in the UK and abroad. Our report, Under One Roof: Will polyclinics deliver integrated care?, published in 2008, assesses whether polyclinics really can deliver better, more accessible care and bring down costs. The report sets out both the opportunities and risks associated with this model.

Among its other findings, the report states that there have been few rigorous evaluations of the polyclinic model in other countries. It sounds a note of caution to policy-makers in England about the potential risks involved in developing polyclinics and about the transferability of polyclinic models used in other countries. The report goes on to make recommendations to help commissioners develop polyclinics in a way that is most likely to achieve the intended benefits.