Polyclinics

Are larger health centres that provide a greater range of services by GPs the right way forward for England's primary care?

The centres, called polyclinics, have been proposed as part of surgeon and health minister Lord Ara Darzi's review of the NHS.

They have drawn controversy as some are concerned there would be fewer local centres for people to visit, making it more difficult for a number of groups to see a GP.

Fears have also been raised that a polyclinic model could be imposed that is inappropriate for all areas of England.

The latest report on the clinics from the King's Fund thinktank says polyclinics have the potential to reform care but only after a number of issues have been dealt with.

Its review says evidence suggests that bringing together multiple services does not always result in better working practices between professionals.

And while there may be more services on offer, such as X-rays, the quality of care provided may be no better than at current GP practices.

Shifting some specialist services out of hospital could prove expensive, the report adds, and the successful examples of integrated care delivered in polyclinics abroad may not transfer easily to the NHS in England due to important differences in the medical workforce.

Report co-author Candace Imison said that while there is a case for changing how care is provided in England, "benefits will only be realised if the focus is on changing the way we deliver care, not just changing where care is delivered".

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