Health Minister and surgeon Lord Ara Darzi has been tasked by
the Government to carry out a widespread review of the NHS,
both in London and nationally (England), to ensure that patients
can depend on fair distribution and quality of health services,
regardless of personal circumstances or where you live
One proposal generating considerable interest is the setting up
of polyclinics or supersurgeries. The Royal College of General Practitioner (RCGP) agrees that the
concept is worthy of consideration and that it has potential in
providing:
i. choice for patients
ii. a "one stop shop" for health and well-being
iii. access to a wide range of services on good
premises
For some areas of the country, this model will be welcomed by
patients and doctors and could bring great benefits. But as it
stands, the polyclinic or supersurgery idea plays down the
importance of general practice in favour of "Martini" healthcare:
any time, any place, any where - any doctor. While this approach
might suit otherwise healthy and able-bodied commuters who
rarely need to see their GP, it could be a very different story for
older patients or people with long term conditions. As proposals
for polyclinics are advanced, these concerns should be
addressed.
In many areas of the country, we believe that services can be
improved by building on the strengths of general practice. The
RCGP believes that the services provided by GPs and their
practices are essential for a quality NHS in the future because:
i. Patients want personalised care - to see a doctor
they know and who knows them
ii. Patients want healthcare close to home in the heart
of the community - preferably within walking or
pram pushing distance or on a good bus route
iii. Patients want co-ordination of care with GPs liaising
with specialists and hospitals where necessary
iv. GPs work in practice teams able to deal with multiple
conditions at one time and integrate different types of
care for patients
v. GPs provide aftercare for patients discharged from
hospital
vi. GPs provide lifelong care and never discharge
patients
vii. Prevention can be better than cure - GPs work hard
to prevent conditions such as strokes and heart attacks
We are concerned that polyclinics could bring about the end of
the unique relationship between patient and GP; that patients
could be treated as numbers rather than individuals and that
continuity of care will break down.
We also have concerns that polyclinics could be set up in, and
run by, existing hospitals and used as another means of
generating income for the hospital trust. More worryingly, it could
mean that many patients would need to travel further to access
care and many patients, particularly older people and some
vulnerable groups, worry about going to hospitals for a variety of
reasons including the fear of contracting infections such as
MRSA.
What is the RCGP doing?
We believe that our new model of caring for patients - the
federated model - is the best solution for delivering better care for
patients whilst providing all the benefits of polyclinics or
supersurgeries.
What is the federated model?
This involves different GP practices working together in
"federations" or collaborations to deliver a wider range of
quality healthcare services where patients want them - closer to
home - by healthcare professionals they know and trust.
GP teams would be able to provide a wider range of services in
the community and the majority of health problems, including
mental health, would be dealt with by family doctors. GPs would
also have greater access to scans and x-rays, meaning patients
would be sent to hospital only as a last resort. GPs could also
work closely with specialists in the same way as is being
suggested for polyclinics.
Further details are available on our website at
www.rcgp.org.uk/roadmap
GP federations are already working successfully in numerous
areas around the country and making a real difference to
patients' lives - but we want this to become widespread. The
NHS Review should lead to improved services and better care
for patients. GPs and practices want to be central to NHS
improvements and to ensure that new models of care meet the
needs of patients and communities.
We are making our views known to Lord Darzi and the
Government but you can also have your say on the “Our NHS”
website:-
Our NHS Questionaire
Together we can change the NHS for the better.
The RCGP and Lord Darzi’s Review of the NHS