Polyclinics

Plans for polyclinics are being discussed as part of Lord Darzi’s NHS Next Stage Review having previously featured in the recommendations of his review of health services in London last year. The idea is to bring together family doctors, specialists and other services more usually associated with hospitals, such as diagnostic testing, minor surgery, blood tests and X-rays.

The term polyclinic has been used to describe a variety of different approaches to uniting these different types of care.  Such reforms could be implemented in a variety of ways, ranging from very large super surgeries, which involve closing current GP practices and moving their services into the new unit, to the so-called hub-and-spoke model where most existing practices continue but share access to a set of new services in one facility.   

King's Fund response

• King’s Fund publishes major analysis on polyclinics

Resources

King's Fund

• King’s Fund Response to the Healthcare for London: A Framework for action NHS London consultation (2008)
• The reconfiguration of hospital services (2007)
• Extending primary care: polyclinics, resource centres, hospitals-at-home (1996, published by Radcliffe Medical Press in association with the King's Fund)

 Department of Health

• Care closer to home case studies. Includes references to polyclinics and polyclinic-style services in the following studies: 
  • ENT (see 'Children's ENT day surgery and joint paediatric audiology clinic, Epsom and St Helier University Hospitals Trust and Surrey PCT', which provides a one-stop shop)
  • general surgery (see 'GPs SI-led minor and intermediate surgical procedures, The Probus Surgery, Cornwall and Isles of Scilly PCT' and 'Primary care based endoscopy clinic - Newcastle', both of which provide one-stop shops)
  • gynaecology (see 'Gynaecology service, South Manchester PCT' and 'The Community Gynaecology Service, Newcastle')
  • orthopaedics (see 'Orthopaedic Clinical Assessment and Treatment Service, Bolton Primary Care Trust') (2007)
• Implementing care closer to home: convenient quality care for patients (2007)
• Implementing care closer to home: convenient quality care for patients: part 1: introduction and overview (2007)

(The 'Care closer to home' publications refer to the movement of services towards one-stop shop clinics.)

• Our health, our care, our say: a new direction for community services (2006)

Healthcare for London

• Healthcare for London: a framework for action (2007) 
• A framework for action: technical paper (2007)

Health Service Management Centre and NHS Institute for Innovation and Improvement 

• Making the shift: key success factors: a rapid review of best practice in shifting hospital care into the community (2006)

NHS Confederation 

• Ideas from Darzi: polyclinics (2008)
• Out of hospital care: how will polyclinics work? – presentations from a seminar (2008)

NHS Institute for Innovation and Improvement 

• How to engage staff in thinking differently around shifting care closer to home (2007) 
• Care outside hospital (2007)

Royal College of General Practitioners 

• The future direction of general practice: a roadmap (2007)

Royal College of Physicians and Royal College of General Practitioners 

• Making the best use of doctors' skills: a balanced partnership (2006)

• Under One Roof: Will polyclinics deliver integrated care?
• News in context: Lord Darzi's NHS next stage review
• Healthcare for London
• Care closer to home project (Department of Health)