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Hospital and GP reforms 'flawed' Hospital and GP reforms 'flawed'
(about 2 hours later)
The government's drive to push care out of hospitals and into "polyclinics" is flawed, an expert has said. The government's drive to push care out of hospitals and into new polyclinics is flawed, an expert has said.
After studying pilot schemes, Professor Martin Roland, of Manchester University, said focusing GP care in polyclinics would harm patient choice.After studying pilot schemes, Professor Martin Roland, of Manchester University, said focusing GP care in polyclinics would harm patient choice.
Polyclinics are effectively super-surgeries housing GPs alongside other services such as hospital care, physios and social services. Polyclinics are effectively super-surgeries, housing GPs alongside other services such as hospital care, physiotherapists and social services.
But the government said the changes would help improve the health service. But the government said polyclinics would not be forced on authorities.
Primary care trusts have already been told to start setting up polyclinics, but I think the government has to rethink its approach Professor Martin Roland, of Manchester University Health Minister Lord Darzi said: "We are not imposing polyclinics on anyone.
Professor Roland also said there were concerns over the quality of care provided by the super-surgeries, while moving services out of hospitals was inefficient. This is about the local NHS making changes that suit people's needs: clinically led, locally driven and putting the public first Health Minister Lord Darzi
"The 150 health centres announced in the NHS Next Stage Review Interim Report are additional, new capacity, and we have not suggested merging small practices.
He said it would be up to primary care trusts to decide what was best for the communities they served.
Lord Darzi added: "People want healthcare that is more personalised and convenient...This is about the local NHS making changes that suit people's needs: clinically led, locally driven and putting the public first."
Serious concerns
Ministers envisage relatively minor hospital treatment, such as dermatology, minor surgery and diabetes care will be increasingly done in these centres.Ministers envisage relatively minor hospital treatment, such as dermatology, minor surgery and diabetes care will be increasingly done in these centres.
But Professor Roland, who carried out an analysis of 30 demonstration sites that are being used to pave the way for the changes, said he had serious concerns. But professor Roland said there were concerns over the quality of care provided by the super-surgeries, and that moving services out of hospitals was inefficient.
He said that after carrying out an analysis of 30 demonstration sites being used to pave the way for the changes, he had serious concerns.
He said the current model of GP practices provided more choice and better access than polyclinics.He said the current model of GP practices provided more choice and better access than polyclinics.
He believes that while standards could vary widely, overall they were judged to provide better care than polyclinics. And while standards could vary widely, overall they were judged to provide better care than polyclinics, he said.
Training standards Primary care trusts have already been told to start setting up polyclinics, but I think the government has to rethink its approach Professor Martin Roland, Manchester University
There are no mandatory training standards set out for the doctors and nurses taking on extra responsibilities in the polyclinics.There are no mandatory training standards set out for the doctors and nurses taking on extra responsibilities in the polyclinics.
Professor Roland, who is director of Manchester University's National Primary Care Research and Development Centre, also said there were concerns about hospital consultants running clinics in the community. Professor Roland, director of the university's National Primary Care Research and Development Centre, also said there were concerns about hospital consultants running clinics in the community.
He said the last time it was tried in the 1990s, doctors did less work because of the increased amount of travelling and lack of access to resources such as blood testing labs and scanners. He said last time it was tried in the 1990s doctors did less work because of the increased amount of travelling and lack of access to resources such as blood testing labs and scanners.
Professor Roland, who has written a piece for the British Medical Journal on the subject, said: "The government is pushing ahead with this. Professor Roland, who has written for the British Medical Journal on the subject, said: "Primary care trusts have already been told to start setting up polyclinics, but I think the government has to rethink its approach."
Funding criticism He said the current funding system discouraged hospitals and GPs from working together because hospitals were only paid per patient treated and so had no interest in keeping patients in the community.
"Primary care trusts have already been told to start setting up polyclinics, but I think the government has to rethink its approach."
He said the current funding system discouraged hospitals and GPs from working together - hospitals are only paid per patient treated and so have no interest in keeping patients in the community - and needed to be tweaked.
His criticisms come after doctors hit out at the government's plans.
Last week the British Medical Association said polyclinics were being forced on to the NHS even when there was no need for them.Last week the British Medical Association said polyclinics were being forced on to the NHS even when there was no need for them.