|Planning for New NHS Services & Polyclinics|
Development & Consulting Ltd
Herts HP3 0HJ
Tel 01442 817217
Fax 01442 879647
Registred in England
Company No 3326461
C21 Herbal Gardens
9 Herbal Hill
Lord Darzi is undertaking a national review of the NHS and has already
made suggestions for London. Judging by his preliminary report for the
whole NHS, we suspect the rest of England will be following the London
lead. The reports seek the establishment NHS
Polyclinics, and sites have already been identified, including Hemel
Hempsted. These buildings are grouped GP surgeries with
outpatients and day case surgery facilities in one place.
Since 1999 Archway Development and Consulting has been trying to develop such polyclinic in Hertfordshire, and we put in a bid for two sites. At the The the PCT opposed us. Now the NHS wants what we proposed.
The essay below was written with Archway Surgery, in mind following local worries after we had obtained planning permission to use the surgery building as offices or flats. This is of 2004-6 vintage, but since we were ahead of our time it remains relevant:
The Government suggested a new vision for General practice in 2005:
vision first seen on 10th March 2005 (see Jo Whitehead's
Archway Surgery Bovingdon obtained Planning Permission for the building.
We never planned to close the service. Indeed we worked hard in the
recent handover to prevent the PCT distributing the list on Drs Bulger's
retirment from the surgery.
The Government has pushed forward many reforms, many of which were detrimental to smaller practices. A small practice, despite all clinical evidence to the contrary, was regarded as a “bad thing” by both the Government and Primary Care Trusts. l Dame Jane Smith (Shipman Report) ticked them all off for the unofficial policy to close small practices. Two years ago two small practices were closed in Dacorum. The NHS Plan in 2000/1 singled out small practices for specific action without any evidence. At Archway we saw that coming, and had already formed a grouping with two other small practices, working under new contracts called PMS. This grouping of practices still exists.
The final Shipman Report were much more helpful to small practices than PCTs and ourselves expected. Until her final reports Dame Janet was expected to damn the smaller practices. The converse was true However the Government is still moving on with its grander vision and Lord Darzi adds a surgical tilt to the vision.
Archway Surgery is determined to provide our current services. We need to plan ahead and be prepared for the next round of Government and PCT initiatives. The way things are going at the moment, this building will have to be 100% office space simply to do the paperwork involved in the New Modern Dependable NHS!
Payment By Results, and the advent or return of Practice Based Commissioning is a further imperative to keep our options open.
As from April 1st 2004, General Practice as we knew it was abolished:
G.P.s will need to work together and share larger premises to provide all the services. We believe this will have to be in the form of Polyclinics, akin to American Health Maintenance Organisations. Already the NHS has been working with Kaiser Permanente see http://www.nhs.uk/nhsupdate/news.asp?newsid=746
G.P.s remain private enterprises and control expenditure. Unless G.P.s keep our expenses down we have no take home pay. So the money that goes general practice is unlikely to be wasted.
The Primary Care Polyclinic
If such a service was developed and had a critical mass of registered patients it would be possible to run its own transport service bringing patients in.
We had two sites in mind. One on the A41 and another in Maylands Avenue. Click here to see the map
Archway surgery has planning permission to turn the current surgery into a residential flat or office.
Informal discussions are taking place with other practices and landlords seeking long term solutions to increasing health care needs. If we develop larger premises with other practices it will be on the basis of one building and two or more practices sharing the building and resources, and keeping a local presence in the villages.
To create more space we purchased the flat next door, no 54 (the flat that also goes above the arch of the surgery). This gave us an extra car parking and a disabled bay. In 2003 we obtained planning permission the ground floor of that flat as an office/storeroom, as an interim measure while we seek larger premises with other practices.
Dacorum Primary Care Trust was violently opposed to developing any polyclinics in 2003/4 so we invested our resources in areas witch had more forward looking, and advanced PCTs. We purchased a large surgery building in Kelvedon, Essex (click for pic). Kelvedon Surgery web site is here .
In spring 2005, Dacorum and Three Rivers PCTs are conducting an Estates review. All things are possible again. Since then the PCTS have merged and once again more reviews.
In 2007 the current PCT would seem to welcome the development of polyclinic and super surgeries. Now the PCTs have disolved and we have a new PCT this year, West Herts PCT. so it is all change again.
|Archway Development & Consulting Ltd 54 High Street Bovingon Herts HP3 0HJ Tel 01442 817217 Fax 01442 879647 email here Registred in England Company No 3326461 Registered Office C21 Herbal Gardens 9 Herbal Hill London EC1R 5XB|