1:50pm Thursday 28th February 2008
By Alex Galbinski
The Government wants to bring health services into the community so patients can be treated closer to home and prevent them going into hospital unnecessarily.
Health minister Lord Darzi has proposed this could happen through the use of polyclinics - a sort of one-stop clinic to replace single-doctor practices. His vision would see 150 of them spring up across London in the next ten years.
Chas Hollwey, chief executive of Barnet Primary Care Trust (PCT), which is responsible for planning, securing and improving health services in Barnet, prefers to talk about a "hub and spoke" model of "primary care centres" rather than all-singing, all-dancing polyclinics.
Here, existing GP practices or "spokes" would link to a local "hub" for specialist services, and the borough's two community hospitals, Finchley Memorial Hospital and Edgware Community Hospital, would be part of this model.
He explains: "There will be one centre in each location where we will have a number of GPs, therapists and other practices."
One primary care centre, in Vale Drive, Barnet, has opened. It is a £5 million integrated health centre which offers services for children and adolescents with special needs, dental services, and speech and language therapy, among other services.
While GPs have still not moved into the building - which was opened in October 2005 - they are expected to arrive next month.
Mr Hollwey says: "For us, a primary care centre is a location which has both community services and primary care services - GP services - in one building, and may also have with it diagnostics services, such as outpatients from secondary care hospitals."
"For example, ear, nose and throat services or dermatology services might run from a primary care centre.
"I think there is a need for investment in primary care so more people can be treated locally rather than have to travel.
"There is a need for more joined-up care. You can have an X-ray at a primary care centre rather than have to wait to go to hospitals."
The PCT is planning to open one primary care centre in Cricklewood and another in Colindale, but not until around 2012 after the areas have undergone regeneration.
It envisages basing another primary care centre at Barnet Hospital so patients who do not need to go to A&E or be admitted to a bed could receive care, freeing up junior doctors.
Another hub could be based in either Friern Barnet or Brunswick Park, alongside Oak Lodge Children's Centre in Oak Lane, East Finchley, which should be opening later this year. Some people fear this model would see GPs forced to move, a notion he dismisses.
"We definitely won't be doing that. We would not force GPs to go into a building they don't want to go into," he says.
According to him, the GP-patient relationship would not be compromised.
"We don't believe the development of primary care centres would in any way undermine such a relationship. It will enable the GPs to provide greater services to patients."
The primary care centres could be financed through the PCT's own budget, agreements with developers, or NHS funding. But Mr Hollwey does not rule out private finance initiatives, such as the Local Improvement Finance Trust (LIFT) project which is behind the Vale Drive clinic.
"It gives us health services for the population. We are not dogmatic about how we improve," he adds.
And what does he say to the argument that polyclinics - or in this case primary care centres - can take funds away from hospitals?
"Our plans are integrated with Barnet and Chase Farm Hospital's plans," he insists. "We are moving dermatology outpatients out of Barnet and Chase Farm Hospitals and the Royal Free hospital to offer the services locally.
"It's moving the care out rather than the hospitals losing income.
"We are trying to work in partnership with each hospital."
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