Redbridge ‘super-surgeries’ plan on hold

Posted on July 22, 2011. Filed under: GP-led health centres, Polyclinics |

London 24 | by Tim Dickens, Reporter | Friday, July 22, 2011 

Despite the “great success” of the 20,000 capacity Loxford Polyclinic in Ilford Lane, Ilford – which nearly 17,000 people have registered to use in just over two years – plans for more polyclinics have been put on hold.

The brakes have been put on the plans while health minister Andrew Lansley decides on the future of the Health for North East London programme of changes, which include the proposed closure of the borough’s only A&E department.

In 2008, health bosses declared plans for a polyclinic on the site of King George Hospital, Barley Lane, Goodmayes, that would ease pressure on its A&E.

But the future of any GP and urgent care at the Goodmayes site hangs in the balance as part of the wider review to be considered by Mr Lansley from tomorrow (Friday).

A spokesman for Outer North East London NHS (ONEL) said: “Under the current NHS reforms it is now GPs, not politicians, who must take the lead in deciding which services are provided locally, taking on board the views of their patients and other stakeholders.”

Opened by Lord Darzi in April 2009, Loxford’s clinic was the first purpose-built polyclinic in London and a recent patient survey revealed 90 per cent of patients rated the service as good, very good or excellent.

Polyclinics include GP and outpatient services, minor operation and urgent care clinics.

The ONEL spokesman said: “This doesn’t mean that no new health centres or other facilities will be built going forward – just that we await the decision on the Health for North East London plans before GP consortia can reassess the picture locally.”

A decision on the future of King George Hospital’s A&E and labour ward is expected from Mr Lansley later this year.

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NHS managers question viability of polysystems rollout

Posted on February 8, 2010. Filed under: News stories, Polyclinics | Tags: |

Pulse | By Ian Quinn | 8 February 2010

Exclusive: NHS managers have raised serious doubts about the viability of controversial plans to group GPs in polysystems and transfer hundreds of thousands of hospital cases to them.

Documents uncovered by Pulse demonstrate concerns within at least one PCT that some of the so-called polysystems being launched by NHS London could end up costing more money than they save.

The revelation comes with the BMA urging GPs to attend a rally at its headquarters on 25 February – where GPC chair Dr Laurence Buckman will be one of the key speakers – as it spearheads the battle against the ‘unproven’ polysystems model.

A report reveals NHS Westminster, meeting two days before NHS London unveiled plans for more than 100 polyclinics across the capital, claimed the policy of having groups of GPs practices serving up to 80,000 patients, based around major ‘hub’ buildings, was not practical in large areas.

Areas including Paddington, Queens Park and the northern half of central London do not have ‘sufficiently sized premises’, it said.

The report also raises fears over the affordability of the polysystems proposals.

‘A key principle in designing each polysystem is that it costs less than the existing service and delivers savings,’ it adds.

‘This requirement has a fundamental impact on the feasibility of delivering certain elements… It will be essential sufficient activity and funding can be diverted from A&E to the new service to make it financially viable,’ says the report, adding: ‘This may not be achievable in certain parts of the PCT.’

The report claims there is also a danger of polyclinic buildings threatening each other’s viability.

Neighbouring Kensington and Chelsea PCT is developing a major polysystem hub at St Charles Hospital, which Westminster claims means its cross-border plans ‘would not make sense from a service or economic perspective’.

The development of polyclinics in London has been fraught with controversy, with the economic crisis forcing a massive scaling back of the original plans put forward by Lord Darzi and now fears growing over the viability of the hub-and-spoke model.

A report by NHS Hillingdon reveals the evidence for its polyclinics strategy was branded as ‘weak’ by NHS London itself, which said it lacked evidence of affordability and how GP practices would work together, as well as ‘justification’ of the chosen sites.

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PMS funding diverted to pay for ‘polysystems’

Posted on February 4, 2010. Filed under: News stories, Polyclinics | Tags: |

Pulse | By Ian Quinn | 4 February 2010

Exclusive: NHS managers are planning to scrap growth funding for PMS practices across London and use the cash to fund a new network of 100 ‘polysystems’ – the successors to Lord Darzi’s polyclinics.

Plans unearthed by Pulse show trusts plan to make huge savings by denying growth money to practices in the capital, and have earmarked it to finance their latest policy drive rather than pay off deficits.

Polysystems are designed to serve populations of up to 80,000, working around polyclinic hubs many of which may be run by private providers.

The Department of Health’s policy implementation arm, NHS Primary Care Commissioning, has lent its backing to a policy developed by controversial PCT NHS Camden to finance polysystems using PMS cash.

An NHS Camden policy document posted on the PCC website as a model for other trusts sets out plans in which ‘the PMS growth money will be taken out and invested in the polysystem’.

At a meeting of PCT and DH representatives, PCC endorsed the Camden model and urged trusts to use ‘contractual levers’ to squeeze money out of PMS.

It said: ‘NHS Camden has conducted a PMS review and illustrated how to reinvest into a 40% shift from acute medicine to a primary care polysystem.’

NHS North Central London – a group of five PCTs including NHS Camden – plans to move 87,291 outpatient appointments into polysystems in 2011/12, which it claims will save more than £20m a year.

Elsewhere, PMS practices in NHS Newham have been served with breach-of-contract notices after refusing to sign up to plans to cut funding (see left).

NHS London last week announced potential sites for more than 100 polyclinics across London, with care coordinated around each in a polysystem. But it admitted there was a high risk of local and national opposition jeopardising the plans, which will dramatically reduce the number of singlehanded practices and require those GPs who take part to extend their opening hours.

Dr Chaand Nagpaul, GPC negotiator and a GP in Stanmore, Middlesex, said: ‘Polysystems are being imposed on GPs as a political imperative rather than being led by clinicians. It’s the antithesis of the rhetoric we were given in the Darzi report. Just taking money from PMS practices to fund them is a highly crude approach that can only serve to further alienate GPs.’

The BMA is staging a rally at its headquarters on 25 February to protest against NHS London’s plans, and is strongly opposing the polysystem drive.

Dr Kevin O’Kane, chair of the BMA’s London regional council, said: ‘Polysystems are being used to bring in multinational companies and increase competition. This will enable them to replace small practices.’


GPs fighting against NHS plans to slash the terms of their PMS pay have been threatened with breach-of-contract notices.

Dr Surendra Dhariwal, a GP in Newham, east London, heads up a group of more than 30 PMS practices who have consulted lawyers in an effort to stop NHS Newham bringing in new targets and cutting the funds per patient.

Dr Dhariwal said: ‘The attitude of the PCT is totally alien. All the PCT staff who negotiated the first PMS contract and understood its benefits have now left.’


Networked polyclinic: A hub-and-spoke model with various GP practices linking to the hub for specialist services. Hub premises could be an existing GP practice, a private provider, a new-build or a new existing building.
Hospital-based polyclinic: To be based at the front of the hospital, with a network of care operating from community locations.
Same-site polyclinic: Services such as GP practices provided from the same building. The GP practices could run independently or merge.

Source: NHS London report

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Conservatives urged to step up role of polyclinics and private sector

Posted on January 29, 2010. Filed under: News stories, Polyclinics, Providers | Tags: |

Pulse | By Steve Nowottny | 29 January 2010

The founder of a private provider running a series of GP practices across the country has issued a public plea to the Conservative party to maintain the ‘momentum’ of the polyclinic rollout if they win the general election.

Dr Jeremy Rose, clinical director and founder GP of The Practice, which currently runs nine GP practices and four GP-led health centres, and plans to open a further four shortly, also urged the Conservatives to bring in more private providers to help drive up health outcomes.

Writing in the Times, Dr Rose argued that polyclinics had helped shift care to the community and improve patient choice.

‘With a change in government and policy, momentum will inevitably be lost,’ he wrote. ‘Many of the reforms in the manifesto are not new, but combined and introduced in a sustained way, they could effect change in the NHS.’

‘Facilitated by the polyclinic concept with an array of GP services, outpatient clinics, health information and so on in one place, the number of clinicians a patient needs to see and the number of clinics they attend is reduced, thus speeding up the process.’

He added: ‘As the NHS has evolved over recent years the presence of independent organisations has increased and a notion of payment by results is becoming more widely accepted. At the core is a drive for clinicians to achieve the best health outcomes for everyone, wherever they live.’

‘The possibility of more independent providers could be a catalyst for just this.’

Pulse reported earlier this month that the Conservatives have opened up talks with a series of private providers after pledging to step up the role of the independent sector in the NHS. The party said talks were ongoing with ‘a wide range’ of providers from the private and voluntary sectors.

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Health bosses come under fire over polyclinic plan

Posted on January 25, 2010. Filed under: News stories, Polyclinics |

Ilford Recorder | ZJAN SHIRINIAN | 25 January 2010

THE Redbridge health roadmap was torn apart by an angry councillor who warned the borough would be lumbered with five run down polyclinics if it pressed ahead with plans to build more of the super surgeries.

Fairlop Polyclinic is one of four new health centres set to be built over the next four years to go alongside the existing Loxford Polyclinic, Ilford Lane, Ilford.

But the centres – housing GPs and a host of other specialist health services – are sparking unease.

At a coffee morning hosted by campaign group Barkingside 21 on Thursday, residents had the chance to grill Rob Meaker, chief officer for the Fairlop Polysystem, and Adrienne Noon, head of communications and marketing for NHS Redbridge.

In an angry outburst, Conservative Cllr Loraine Sladden – who was at the meeting in Fullwell Cross Library, High Street, Barkingside – warned building more polyclinics would be a mistake.

She said: “If you’re hell bent on polyclinics, at least get Loxford right first of all.

“A good business wouldn’t open another company if they have problems with the first one.

“Do it over three years and then come back if it works.

“Otherwise we will be left with five run-down polyclinics.”

Mrs Noon said: “Loxford has teething problems like any new entity.

“There are issues with the walk-in side of things and we are addressing those.”

She also told residents Fairlop Polyclinic, which would also serve Fullwell, Barkingside, Clayhall and Hainault, would be unable to house every health service, meaning some may have to travel further for medical care.

She said: “What we’re trying to do is say if there is a prevalence for this thing or that, lets provide for that in the closest polyclinic.”

She also denied suggestions doctors would be forced to close and move into the new super surgery.

The proposed closure of King George Hospital’s A&E was another topic at the meeting.

People raised concerns about the “complexity” of the public consultation’s questions and appointment waiting times.

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Patients to voice their views on NHS services in Tower Hamlets

Posted on January 18, 2010. Filed under: News stories, Polyclinics |

East London Advertiser | 18 January 2010

RESIDENTS are being given the chance to voice their views on the future of health services in the East End at an NHS roadshow.

As part of the Health for North East London programme, services across the area are being transformed over the next 10 years which could see changes across seven primary care trusts, including Tower Hamlets.

And residents are being invited to four different locations from Thursday where NHS staff will be on-hand to give out information and answer any queries about the proposals.

Under the proposed changes, every patient in Tower Hamlets could soon have a ‘super health centre’, known as a polyclinic, on their doorstep where they could go for minor surgery or even give birth, rather than to their nearest hospital.

And the Royal London Hospital in Whitechapel would become one of only two major acute hospitals in the area.

The roadshow will be based at the London Muslim Centre in Whitechapel Road on Thursday from 10am-4pm, Tesco in Bromley-by-Bow on January 29 from 10am-4pm and Asda on the Isle of Dogs on Friday February 5 from 10am-7pm.

It will also be in the Royal London’s Outpatients Department on Wednesday February 10, from 9.30am-12.30pm.

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Polysystems launched in NE London

Posted on January 4, 2010. Filed under: News stories, Polyclinics | Tags: , |

Nursing in Practice | Press Association | 4 January 2010

North-east London GPs are to get the power to decide how and where healthcare budgets will be spent, as a primary care trust becomes the first in the country to hand over its commissioning function.

NHS Redbridge has disbanded its three practice-based commissioning clusters and replaced them with five polysystems to represent the interests of the borough’s 51 general practices.

In a move that could eventually give family doctors control of a £400m budget, the new polysystems are designed around a “hub and spoke” model, with each covering a distinct geographical area.

At the “hub” is a multipurpose polyclinic, which will offer a range of services, including outpatients and diagnostics, surrounded by local hospitals, pharmacies and surgeries to make up the “spokes”.

Each polysystem is run by a board of local GPs, who may be given responsibilities to commission services and meet targets from the Department of Health and NHS Redbridge.

Local GP Narinder Sharma, Clinical Director for Loxford Polysystem, said: “Health needs vary from area to area and being able to focus the appropriate resources on specific areas as well as anticipate future health trends is a great step forward.”

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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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Redbridge: polyclinic strategy mapped out

Posted on December 19, 2009. Filed under: News stories, Polyclinics | Tags: |

Ilford Recorder | NHS Redbridge | 19 December 2009

FOUR polyclinics at the heart of future healthcare in Redbridge could be developed in the next four years.

NHS Redbridge says it is pleased with the impact Loxford Polyclinic has had since it opened in April and has released details of the remaining four super surgeries, which it hopes will be running by 2013.

Work begins next year on the Seven Kings polyclinic system, linking health centres and medical surgeries with polyclinics, and a surgery could be developed on the King George Hospital site, Barley Lane, Goodmayes.

Health officials will look at systems in Wanstead, Fairlop and Cranbrook in 2011, 2012 and 2013, but have not decided in which order.

Research will be done to gauge needs in the communities, which will be compiled with social and economic information.

NHS Redbridge’s borough managing director Conor Burke said: “The proposed changes to services in outer north east London echoes this approach, suggesting the majority of urgent healthcare needs could be out outside hospitals in a polyclinic setting.

“Our five polysystems will increasingly be able to direct funding where they think it is best used in their neighbourhood, while still ensuring we meet national quality standards.”

The Wanstead polysystem could have a clinic at South Woodford Health Centre, High Road, South Woodford, and the Fullwell Cross Health Centre, Tomswood Hill, Barkingside, is the preferred option for Fairlop.

There is no obvious site for Cranbrook yet.

Loxford’s polyclinic has enticed nearly 1,000 new patients to register with GPs.

The spokesman said: “The lessons we’ve learned will prove invaluable when it comes to opening the remaining four polyclinics.

“One of Loxford’s strongest assets is the work of its community panel and this input will be replicated in the planning of the other clinics.

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NHS Westminster: GP-led Health Centres & Polyclinics

Posted on December 15, 2009. Filed under: GP-led health centres, Polyclinics, Providers, Reports/papers | Tags: , |

NHS Westminster | Committee Report | Health Consultations and Service Development | 15 December 2009 [word]

GP-led Health Centres

The introduction of GP-Led Health Centres is a nationally driven initiative to extend access to primary care services in response to the findings of Lord Darzi’s review that notes access as a significant concern for patients and service users.

The minimum services specified by the Department of Health for the GP led health centres were as follows:

  • Core GP services
  • Open 8am to 8pm 7 days a week
  • Bookable GP appointments and walk-in services
  • Registered and non-registered patients.

London PCT’s were asked to commission at least one GP-Led Health Centre by March 31st 2009.

In 2008, NHS Westminster initiated a programme of work to procure 2 GP-Led Health Centres for the north and south of the borough in areas of highest health need.  Unfortunately in the Victoria/Pimlico area difficulties were encountered in finding suitable premises for this new service and therefore we have not been able to proceed. We remain committed to providing extra GP services in the south of the borough and are currently exploring all available options to ensure that we deliver the best services possible for local people.

The contract for the GP-Led Health Centre in the north of the borough was awarded to Malling Health LLP and premises for the service have been identified in Queens Park.

A temporary premises solution has been secured while the permanent location is being made fit for purpose.  The GP led health centre opened in this temporary location on 26 October 2009.  The service is called Malling Health at Westminster.  The practice is open for patients 8am – 8pm, 7 days a week at Woodchester Square, W2.  The practice is adequately staffed with clinical and administrative personnel.  The Practice is expected to move into the permanent premises by June 2010.

Whilst in the temporary location, Malling Health will be operating under the same contractual arrangements as they will in the permanent location, including the provision of the full range of services within their contract.


NHS Westminster is consulting with residents in two areas on the development of new Polysystems for the provision of out-of-hospital and primary care services. The two areas have been designated as Queen’s Park and Paddington – which covers Queen’s Park, Harrow Road, Westbourne, Bayswater, Lancaster gate and Hyde Park – and Central Westminster – which covers Bryanston & Dorset Square, Marylebone High Street, The West End, Abbey Road, Maida Vale, Little Venice, Regent’s Park, Church Street.

A polysystem is simply a network of community health services – clinics, health centres and GP surgeries – which all work together to care for patients.  It can organise for patients to get the care they need more efficiently, support patients in getting more care nearer to home and reduce the number of trips patients have to make into hospital.

GPs will be able to offer tests, appointments and treatment more quickly and conveniently.  It will also be easier to get an urgent appointment or go to a walk-in service near to home or work.  It can offer more health services in a community setting.  Examples include:

  • urgent care and walk-in services
  • diagnostics such as blood tests, x-rays and ultrasounds
  • community nursing
  • physiotherapy, occupational therapy and podiatry
  • minor surgery
  • hearing tests and hearing aid fitting
  • obstetric and maternity appointments
  • support to help with a long term condition
  • outpatient clinics
  • mental health clinics
  • sexual health clinics.

It will offer these services alongside the traditional community health services (GPs, NHS dentistry and pharmacies) and well-being services from the local authority from housing and benefits advice to debt counselling or support in getting back to work.  When a GP surgery becomes part of a polysystem, patients will still see their own GP as before.  In addition, they will also be able to see the other GPs and healthcare professionals that are part of the network.

NHS Westminster is running two separate consultations, one in each proposed polysystem area.  The proposals have been developed by local Practice-Based Commissioning Clusters in partnership with NHS Westminster to reflect local needs and experience.  Although the NHS London policy of developing polysystems is being implemented by NHS Westminster, it is important that each one is tailored to the needs and views of local residents, patients, stakeholders, GPs and other professional clinical staff.

All stakeholders on the NHS Westminster database will be contacted in the relevant areas and invited to contribute to the consultation.  NHS Westminster will also be offering stakeholders the opportunity to attend meetings to discuss and listen to local views.  Online questionnaires and response mechanisms are also being made available and consultation materials will also be available online, in GP practices and other NHS facilities as well as in libraries.

Feedback from the consultations will be collated and analysed.  Separate reports will be created for consideration by the NHS Westminster Board and will be made available online and in a feedback document to stakeholders and respondees to the consultation.

The NHS Westminster Board will then consider the responses to the consultations in developing the service specification and implementation plan.

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GP-led Health Centre: The Facts

Posted on December 15, 2009. Filed under: GP-led health centres, News stories, Polyclinics |

James Plaskitt MP | accessed 15 December 2009

Many articles have appeared in the local and national press recently which appear to suggest that the government is trying to replace GP surgeries with ‘polyclinics’. We are not. The record needs to be put straight, so let me be unequivical:

1. Local communities can choose whether they want these new clinics or not.

2. The government is not replacing GP surgeries with polyclinics. They will operate alongside each other.

3. No money will be diverted from other areas of primary care funding.

People have been telling us that they place very high value on their GP service, but they also want more choice and more convenience in accessing primary care. Listening to these concerns, we are providing £250 million to build new state-of-the-art GP-led health centres to be open between 8am and 8pm seven days a week, providing pre-bookable and walk-in appointments. The media has referred to these centres as ‘polyclinics’.

These so-called ‘polyclinics’ are intended to operate in addition to existing GP surgeries. No GP surgeries are being closed as a result of the government’s changes. GP-led health centres are intended to provide a more convenient patient access service, with the co-location of a number of clinical services in a single health centre. They will do more than your local GP can – for example, run diagnostic tests on the spot, rather than having to send samples off to a lab. They will offer convenient bookable and walk-in appointments, designed to cater to those who need flexible access, for example busy families or commuters. You will be able to remain registered with your local GP and still visit a polyclinic if and when you want to.

But we know that ‘polyclinics’ are not suitable for every community. In London, for example, people have welcomed the proposals as a more convenient way to see a doctor. In rural areas, there may be less need for such centres. We think that local communities should have the final say in whether they should have one of the new health centres. So no community will have these centres imposed upon them against their will: it will be up to local communities to choose whether they want them or not.

There is no question of any NHS primary care services being ‘privatised’. The money for these new GP-led health centres will be additional funding from central government – no money will be diverted from existing primary care funding. The media seems to think that polyclinics will be ‘privatisation by the back door’. Most GP surgeries are in fact small businesses, privately contracted by the government to provide a service. It will be the same principle for the new GP-led health centres.

It is disappointing that the British Medical Association is speaking out against these changes, but it is not surprising. The BMA represents the interests of doctors who operate as small businesses and their own interests to protect. The BMA actually opposed the establishment of the NHS in 1948! Some GPs in the constituency have even been distributing misleading BMA campaign materials using the NHS logo – something which is clearly illegal, and which I have reported to the Department of Health.

Finally, I should point out that this review is not something that is being carried out by politicians and civil servants sitting in Whitehall. It is being conducted by 1000 clinicians from across the front line of NHS primary care: consultants, nurses, surgeons, dentists, and anaesthetists. It is being led by the Minister for Health, Lord Darzi, who is a world-famous oncologist and who the Prime Minister appointed to the government last year to lead the review because of his wealth of experience in the NHS.

This government firmly believes that local health services should form the cornerstone of the NHS. Under the Labour government, investment in GP surgeries has increased from £3 billion to £8 billion. We have ensured that there are 5,318 more GPs across the country than there was ten years ago.These achievements have only been possible because of the significant investment that the Labour government has put into primary care. And the investment will continue under this government.

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NHS starts consultation on East Harrow polyclinic plans

Posted on December 14, 2009. Filed under: News stories, Polyclinics |

This is local London | By Jack Royston | NHS Harrow | 14 December 2009

RESIDENTS are being asked their views on the future of “below average” GP services in East Harrow.

NHS Harrow, formerly Harrow PCT, is consulting on plans to turn Belmont Health Centre, in Kenton Lane, into a polyclinic, meaning it will open from 8am to 8pm seven days a week.

If the proposals go ahead the centre will offer enhanced services and act as a “hub”, working together with smaller GP practices in the area.

NHS Harrow hopes to complete the project by 2012.

The organisation says patients in the area are less satisfied with GP services than elsewhere in Harrow, with opening hours and appointment bookings among the areas criticised.

Anyone who wants to have their say on the plans can view the consultation document online, at http://www.harrowpct.nhs.uk, or call NHS Harrow on 0208 966 1050.

Responses must be received by 5pm on March 17.

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Wanstead and Woodford lined up for new super-surgeries

Posted on December 9, 2009. Filed under: News stories, Polyclinics | Tags: |

Guardian Series | By James Ranger | 9 December 2009

AFTER months of speculation, health bosses have finally revealed a choice of two sites where they want to put Wanstead and Woodford’s first super-surgery.

The sites identified for the polyclinic, where most GPs will be expected to move, are at the existing South Woodford Health Centre on the High Road or the site of the former Wanstead Hospital on Hermon Hill.

Polyclinics are to open across the UK to ease pressure on Accident and Emergency wards and offer a range of medical specialisms, GP services, and minor operations.

London’s first super-clinic opened earlier this year in Loxford but neighbours of the two proposed sites are worried about the impact they could have on an already congested area.

Denise Coe, 63, of Derby Road, drives past the health centre on her commute to work. She said: “I think the polyclinic would be a good idea, but I’m sure it would make the traffic even worse.

“Another thing they would have to improve is the parking, possibly making the car park at the back bigger. At the moment, if you want to use it you have to get down there at about 7.30 in the morning.”

Barry van Loen lives in Tempus Court, next door to South Woodford Health Centre, and represents the residents’ association.

He said: “It all depends on how busy its going to be. My wife did a survey and she voted against it, because obviously it will increase traffic around here.

“If the other site is Wanstead hospital, then surely that would be much better as its bigger and more set up to deal with parking?”

Residents can get involved in the discussions over the location of the polyclinic by volunteering to sit on the NHS Redbridge’s community panel.

For more information call Amy Burgess for details on 8926 5048.

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Blackpool gets ‘Darzi’ style PACS

Posted on December 7, 2009. Filed under: GP-led health centres, News stories, Polyclinics | Tags: , |

E-Health Europe | NHS Blackpool | 7 December 2009

NHS Blackpool has implemented a new Agfa PACS system that enable staff working at the town’s state of the art new polyclinic to access and share diagnostic image records with staff at the local hospital trust.

Implemented as an extension of Blackpool, Flyde and Wyre Hospitals NHS Foundation Trust’s existing Agfa Impax PACS, the new system will allow authorised staff working in primary care, community and acute care settings to far more easily share diagnostic image records with health professionals from.

As a result primary and secondary care imaging is now available within both sectors, providing clinicians to easy access to a patient’s entire diagnostic imaging records, no matter where they are working.

Whitegate Health Centre is a new Darzi-style polyclinic in central Blackpool has become the first to benefit from the new system. The £20m health centre was opened by Secretary of State for Health Andy Burnham last month.

The centre has been fitted with a range of hi-tech diagnostic tools, including one of only a few MRI scanners in a primary care centre in the country, as well as ultrasound suites and a state-of-the-art X-ray facility which delivers a detailed image within ten seconds.

The new health centre, which was commissioned by NHS Blackpool, also houses a GP Practice, a GP-led health centre, a walk-in centre, dental services and diagnostics.

To enable seamless sharing of diagnostic images the centre has been equipped with Agfa Healthcare’s Impax picture archiving and communications system (PACS), implemented as an extension to the hospital trust’s existing PACS, first installed in 2001. The new deployment includes an additional workflow manager, image storage and a diagnostic reporting workstation.

Images needed by staff working at the Whitegate Health Centre are stored onto a SAN server located in the health centre and then copied to long-term storage and web servers that form part of the acute trust’s PACS.

Because the images are stored within the hospital’s PACS system they are then available for viewing at any of the six sites covered by the trust, where they can be accessed by using any one of the 26 diagnostic workstations or 4,500 networked PCs within the hospital trust and NHS Blackpool.

Richard Day, PACS manager at NHS Blackpool, said, “We are looking forward to providing the best possible imaging service for patients and welcome the opportunity to extend our PACS into the primary care sector.”

Day added: “In addition to giving authorised healthcare professionals working in the new Whitegate Health Centre access to stored images , we could also look to extend this to any other GP surgeries or health centres should they request it.”

Stewart Whitely, radiology advisor at the Whitegate Health Centre, added: “We are delighted with the new PACS system that Agfa Healthcare has installed within the unit. It has significantly increased the entire local area’s capacity and it will help reduce the strain on Blackpool’s Victoria Hospital and allow NHS Blackpool to develop new pathways.”

Jon Hoeksma

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LMCs to investigate career route to suit salaried GPs

Posted on December 3, 2009. Filed under: GP-led health centres, News stories, Polyclinics, Providers | Tags: , |

Healthcare Republic | GP Newspaper | By Tom Ireland | 3 December 2009

Londonwide LMCs is developing a model of ‘intermediate partnership’ to help salaried or sessional GPs.

Dr Michele Drage: sessional GPs need career opportunities

The emergence of federated practices and polyclinics in the capital requires new models of GP partnership, said Londonwide LMCs joint chief executive, Dr Michelle Drage. ‘The current model of partnership does not seem to be providing (sessionals) with the autonomy they are looking for,’ said Dr Drage.

‘We are looking at how to create career opportunities, with the benefits of a partnership but without the millstone round their necks of having to own all the infrastructure.’

One option would allow salaried GPs to become stakeholders and run one of a group of practices without investing in property and infrastructure.

Dr Drage cited The Hurley Group, a GP-led organisation running several practices across south London, as a good example. It has six ‘local medical directors’ employed at its practices who are paid an enhanced salary to take part in practice decision making in the way that a partner might.

These employees can prog-ress to become a profit-sharing member of the group.

Dr Clare Gerada, medical director of The Hurley Group and RCGP vice chairman, said new partnership models were vital to protect the future of general practice.

‘We have to make sure there are leadership opportunities for the next generation. The old days are gone – you can’t slip straight into a vocational partnership any more.’

Londonwide LMCs is also developing services to help small practices form networks to avoid pressure from PCTs in London. Dr Drage said small practices were still being aggressively targeted by PCTs in London because they did not fit in with the move towards larger, networked clinics.

Dr Drage also expressed concern that NHS London’s plans for large ‘Tesco-Metro’ style health centres could undermine continuity of care. She said Londonwide LMCs did not oppose the ‘hub and spoke’ model of polyclinic, as long as the ‘hub’ does not consume investment from existing practices.

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A public consultation has been launched to examine plans to close the A&E at King George Hospital

Posted on December 1, 2009. Filed under: News stories, Polyclinics |

Guardian – Series | James Ranger | 1 December 2009

MEMBERS of the public can now have their say about plans to radically alter the face of healthcare in the borough.

Health for north east London launched its 14-week public consultation into proposals to close the accident and emergency (A&E) service at King George Hospital in Ilford, with all emergency patients being taken to either Whipps Cross in Leytonstone or Queen’s Hospital in Romford.

The proposals also include plans to establish a 24-hour polyclinic at King George, which would aim to treat up to 75 percent of patients currently using the A&E service who, health bosses say, do not actually require emergency care.

The consultation document argues that the existing polyclinic in Redbridge, in Loxford ward, is an indication of how this type of service provision could be used to meet the needs of patients across the borough.

Other plans include the development of services for children and older people, with a view to establishing King’s as a centre for planned surgery.

At a full council meeting in November, councillors voiced fears about the possibility of losing A&E provision and how it would affect patients in the borough.

Members from all parties united to demand answers from the NHS and urged a full and frank engagement with the consultation to ensure that residents’ concerns were heard.

To put your views across, call 0808 2385416, email healthfornel@ipsos.com, or write to Freepost RSAE RCET ATJY, Health for North East London, Harrow HA1 2QG.

Look out for adverts and posters around the borough, or alternatively visit www.healthfornel.nhs.uk to download a questionnaire.

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Build a virtual polyclinic

Posted on November 30, 2009. Filed under: Journals, Polyclinics |

Health Service Journal | BY MARK CAULFIELD | 30 November 2009

Streamlined care cannot be delivered unless clinicians are able to share information easily. Mark Caulfield describes how Tower Hamlets solved the problem with integrated IT.

As the repository for vital patient information, IT systems are at the heart of rethinking services in the post-Darzi era.

It is impossible to redesign more streamlined care pathways – with the patient, not the provider, at the centre – without also considering how different healthcare teams can share information to deliver a joined‑up approach.

This is particularly important for patients with long term conditions, who rely on the support of many different healthcare practitioners, who in turn work in a wide range of settings.

Without shared information – for example, details of recent interventions or current medication – consultations become more time consuming and less effective, not to mention frustrating for the patient.

At NHS Tower Hamlets, we have adopted an ambitious IT programme to support the restructuring of our services into eight new networks. In effect virtual polyclinics, the networks combine clusters of GP practices aligned to local community health services.

The aim is to deliver better and more integrated care, closer to home, in one of the most deprived boroughs in the UK.

To support this new way of working, we needed an integrated IT system that was flexible enough to be used by a wide range of clinicians and that would support comprehensive, PCT-wide data reporting.

We decided to continue our history of collaborative work with healthcare systems supplier EMIS to develop its EMIS Web system into a structure that would work across the whole primary care trust.

Single record

The system allows us to create bespoke consultation templates for different healthcare teams – each feeding data into a single patient record, which can be viewed by different practitioners.

We worked closely with different practitioners to create the right template for their particular service and to agree which other professionals could access the data recorded.

For example, we worked with the community matrons to create templates for patients with long term conditions, based on the templates used in general practice. More recently, we worked with the child protection nurse specialist to create a template to record data for vulnerable children.

Both of these templates can be viewed by GPs and community teams – providing a vital overview of care – and the system automatically captures data from different practitioners’ consultations.

Two years into the project and the system is now widely used by 300 community practitioners, from health visitors to district nurses, and will be implemented across all community teams by the end of 2009.

The benefits of this include:

  • Patients’ electronic records are now more comprehensive, with data entered by different practitioners, giving a rounded view of their care.
  • Data capture to support performance reporting is done in seconds, not weeks, and we can now produce electronic 18-week referral reports.
  • Using the system’s powerful search and reports module, we can track all childhood immunisations across the whole PCT and manage call and recall to improve vaccination rates.
  • Services are being delivered more efficiently. For example, by using a streamlined appointment booking service which has removed duplicate data entry, our physiotherapy admin team is saving seven hours a week.
  • We are developing sophisticated care pathways that will allow us to generate tariff information as well as relating this activity to episodes of care defined by specific problems or conditions.
  • Clinicians have adopted the new system with great enthusiasm – far from having to persuade them to change, we are fighting off requests to extend the roll-out of the system.

Integrated patient care does not stop with the PCT. We plan to implement data sharing with a local hospital trust and with the council’s social care services.

How to deliver joined-up IT

  • Involve clinicians from the outset: listen to their needs and take time to understand how services work before you start to think about IT.
  • Focus on the end result: our focus was not on management information but on using IT to help support new care pathways.
  • Don’t assume that different clinicians need different systems: we identified core similarities in how different practitioners approached a consultation, enabling us to develop a central module that could be adapted to meet service-specific needs.
  • Develop rigorous data sharing agreements: GPs in particular need reassurance about who will access the patient record, how and why
  • Retain flexibility: interoperability with other IT systems is essential if you are to link information with other providers, for example in secondary care.
  • Work closely with your IT supplier: having a direct relationship with those designing the system is a tremendous benefit – saving time and ensuring clear communication of users’ needs.
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New investment in Harrow’s health service

Posted on November 26, 2009. Filed under: News stories, Polyclinics |

Labour Matters | Harrow Labour | 26 November 2009

In the past 12 months three new polyclinics have started work in Harrow.

The Urgent Care Centre at Northwick Park was the first and is open every day from 8am to 11pm at night. The Alexandra Avenue Polyclinic opened in June and is open to anyone to drop in from 8am to 8pm, while just last week the Pinn Medical Centre in Love Lane, Pinner, had its official launch. It too is open from 8am to 8pm for anyone concerned about their health to drop in without an appointment.

These fantastic new facilities, run by local GPs and nurses, are helping to make medical care more local and more accessible. Many services or appointments that you used to have to visit a major hospital to benefit from are now provided at these new polyclinics.

These three fantastic facilities have been championed by local doctors. The superb Pinn Medical Centre is led by the excellent Dr Amol Kelshiker and partners, while Dr David Lloyd, Dr Ken Walton and their partners lead a superb operation at the Alexandra Avenue polyclinic.

When you add to this good news the fact that the Mount Vernon Cancer Centre’s future has been secured and stroke patients are getting their own specialist centre at Northwick Park, the NHS in Harrow is riding high.

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Construction of borough’s first polyclinic gets started

Posted on November 19, 2009. Filed under: News stories, Polyclinics |

Yellow Advertiser | By Suzi Muston | NHS Havering | 19 November 2009

UPMINSTER MP Angela Watkinson was guest of honour at the ground breaking of NHS Havering’s first polyclinic on Friday. 

The £4million clinic, which is scheduled to open in March 2010, will house a number of health services including a minor injuries unit, X-ray and GP services. 

It will be open every day of the year and patients will be able to walk in and see a doctor, nurse or other clinician, between 8am and 8pm, regardless of where they are registered. 

It is hoped the clinic will reduce waiting times in local accident and emergency services. 

Other services will include stroke rehabilitation, guidance on managing long term conditions such as diabetes, and help with health issues such as obesity and smoking. 

A cafe and internet access will also feature in the new centre, along with space that can be used by voluntary and community groups. 

Nursing students from the nearby London South Bank University will also receiving practical teaching in the polyclinic. 

The ground breaking marked the end of the demolition phase and the start of the construction phase of the development on Gubbins Lane, Harold Wood. 

The site was chosen because there is a shortage of GPs in the Harold Wood area. 

An extra three doctors will join the existing number of GPs currently available in Havering.

Email: havering@yellowad.co.uk

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Professor warns of ‘corporatisation’ of UK primary care

Posted on November 11, 2009. Filed under: GP-led health centres, News stories, Polyclinics | Tags: |

Healthcare Republic | By Colin Cooper | 11 November 2009

An international expert on primary care has warned that UK general practice is in danger of following its US counterpart in to ‘intensive care’.

Professor Gordon Moore, who received the President’s International Medal at the conference, said the tradition of general practice here was admirable compared to the ‘dreadful state’ of primary care across the Atlantic.

But he warned that the ‘corporatisation’ of the UK system, the erosion of the continuity of care and loss of established GP skills, were major threats to the future of the profession.

Professor Moore, from the Department of Population Medicine at Harvard Medical School, told the RCGP conference in Glasgow last week: ‘The loss of out-of-hours responsibility, the use of nurses and the emergence of Darzi centres, have all reduced the likelihood that a patient will see their own GP.’

He warned that the over-management of referrals by PCTs could de-skill GPs to the point where the NHS could remove the role completely, and said that the increase in salaried GPs could weaken the quality of general practice.

‘Corporatisation is coming to a place near you, either through private providers or by principals employing salaried doctors. Salaried GPs without a stake in the practice do not show the same drive to keep that practice at the forefront of excellence.

‘The very core of your 60-year story of success could be threatened. The most important things you can do are to remain competitive, alert, and continue to look for the best. General practice in America is on life support and we depend very much on you to lead the way.’

Professor Moore said he had been an admirer of the UK system since spending a year studying general practice in 1988. He highlighted the key strengths of the system as the overarching NHS structure, the product offered to patients, the approach to the selection and training of GPs, and the integrated nature of general practice.

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