Wansworth PCT Health Overview and Scrutiny Committee

Posted on December 23, 2009. Filed under: Federations, Polyclinics, Reports/papers |

Wandsworth PCT | accessed 23 December 2009 [pdf]

Par. 2. Primary care, polyclinics and polysystems. A major focus for the work of Wandsworth Primary Care Trust over the past two years has been the development of plans for primary care. In line with the NHS strategy document Healthcare for London, these plans have concentrated on the development of polyclinics, each serving a population of around 50,000. The approach favoured by Wandsworth PCT has been the development of ‘federated polyclinics’ with an identifiable ‘hub’ but retaining individual GP practices and other primary care services in a variety of locations across the area served. The development of plans has hitherto been structured around three localities: Battersea and North Wandsworth, Putney and Roehampton, and South Wandsworth.

On 30th September 2009 the Board of Wandsworth PCT received a report drawing together the plans for these localities and setting out an overall plan for the development of primary care across Wandsworth. Two factors underpinned this report to the PCT Board: (a) criticism in the ‘gateway’ review of plans for Battersea and North Wandsworth at the lack of a co-ordinated Borough strategy and the need to ensure that investment was fairly distributed across the Borough; and (b) the much tighter than expected financial position of the NHS, with correspondingly more cautious assumptions about the availability of funding for capital developments. This has been reflected in the change of terminology within NHS London, the word ‘polyclinics’ being replaced by ‘polysystems’, emphasising the working together of professionals within a locality without the assumption that this requires investment in a new building.

The report proposes the establishment of five polysystems in Wandsworth: Battersea; Putney and Roehampton; Central Wandsworth; Balham; and Tooting and Furzedown. Primary care services within each of these areas will work together to provide a coherent service pattern and to enable a shift of provision from secondary to primary care. Within each area, from March 2010, there will be a service offering extended hours access to urgent GP-led care. However, the most significant thrust of the report is a retreat from previous proposals for significant new capital investment in polyclinic ‘hubs’. The abandonment of plans for the Putney Hospital site SW15 (Thamesfield), signalled in June 2009, is confirmed, and of the four developments in Battersea and North Wandsworth on which the PCT consulted – Grant Road, SW11 (Latchmere); Doddington, SW11 (Queenstown); Bolingbroke, SW11 (Northcote) and Bridge Lane, SW11 (St. Mary’s Park) – there is only a commitment to proceeding with the smallest, Bridge Lane, within the foreseeable future. The report confirms the intention to establish GP services at Queen Mary’s Hospital SW15 (West Putney) from October 2009, and to follow this with the full development of a polyclinic hub at Queen Mary’s in 2010.

This reduced commitment to capital investment reflects the drastic change in the financial prospects for the NHS. It is justified by an audit of existing primary care premises, which suggests that there is scope for much better use to be made of the existing estate. Nevertheless, it is unclear whether the proposed shift of services from secondary to primary care will be seen by patients as an improvement in quality or access if the primary care settings are scattered around localities as space permits, rather than concentrated in a purpose-built polyclinic hub at the centre of the locality served. The abandonment of the majority of investment plans for Battersea and North Wandsworth is likely to be resented by the community in this area, which had been led to consider the new investment as a recompense for the closure of the much-loved Bolingbroke Hospital.

This matter is being reported to the Council at the request of the Chairman of the Overview and Scrutiny Committee and the Opposition Speaker.

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