Posted by: Witch Doctor | June 5, 2008

Polyclinics – King’s Fund – Under One Roof

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WILL POLYCLINICS DELIVER INTEGRATED CARE?

“For some health communities the development of polyclinic-type facilities could offer real opportunities to establish more integrated, patient-focused care, but only if considerable investment of time, effort and resources is put into their planning and development.

The primary focus should be on developing new pathways, technologies and ways of working rather than new buildings. Co-location alone is not sufficient to generate coworking between different teams and professionals. Investment in change management and strong clinical and managerial leadership will be required.

Commissioners will need to consider new ways of commissioning primary and community services. Services will need to be contracted on the basis of clear quality standards in order to ensure that the benefits of the new models of care are realised.

New approaches to assure the quality of out-of-hospital care and support professional development will be needed. There needs to be a much stronger framework for inspection and accreditation.

A major centralisation of primary care is unlikely to be beneficial for patients, particularly in rural areas. A hub-and-spoke model, where the polyclinic acts as a central resource base in a co-ordinated network of practices, is likely to be more appropriate to achieve the desired development of primary care services.

To maximise accessibility, choice of location is critical – polyclinics should ideally be developed in natural transport hubs. Where this is not possible, finding ways to integrate services more effectively within existing facilities or on existing sites would be preferable to developing a polyclinic in a less accessible location. Improved access by car cannot be assumed given restrictions on car parking imposed by local authorities on any new developments.

Substantial cost savings are unlikely to be made. Costs for some services may increase, unless hospitals can significantly reduce their unit costs and commissioners can manage demand. Scheduling of services will need to be carefully planned in order to ensure effective utilisation of building space and staff time. Developing polyclinics is likely to require transitional funding.

There are significant workforce implications that need to be thought through and addressed.

New developments should not simply be a response to a new national target, but a well thought-out element of a broader strategic plan that responds to local needs.

Any polyclinics developed should be subject to rigorous evaluation to help fill the current gaps in the evidence base.”

Sounds as if those at King’s Fund think the government have been a bit “gung ho” in their approach to polyclinics.

I wonder if they have reflected on why this might be so.

Eh, My Black Cat?

redapple.jpg a red apple ……………………

The Witch Doctor – Link to a random page

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