The proposals – opposed by doctors – recommended a ‘polyclinic model of care’, which would see the creation of health centres offering GP, diagnostic and community health services under one roof.
A meeting of representatives of London’s PCTs agreed the plans, which will make junior health minister Lord Darzi’s vision of healthcare in the capital, published last July, a reality. It is understood that this model will influence Lord Darzi’s wider health service reforms due to be published at the end of the month.
Trust representatives formally approved plans including specialist care for children to be focused in fewer hospitals. A network of between three and six specialist trauma units will also be created, along with specialist centres for complex emergency surgery.
Additionally, ambulance staff should be instructed to take seriously ill patients to appropriate centres and a greater proportion of future spending will be allocated to community services.
PCTs across the capital will now draw up plans and begin consultations on how their services will change.
Ron Harley, Unison London regional officer, said: ‘There are a number of elements that we agree with around changes to proposed pathways for trauma. The one potential problem is around polyclinics – not in themselves but who is going to be running them, and employment security for NHS staff in those polyclinics.’
Anne Duffy, chief executive of the Community and District Nurses’ Association, said: ‘We would have to tread very carefully around anything amalgamating large numbers of patients together. The money needs to follow the ideas.
‘It could mean job losses when you amalgamate large services together and management may decide services are being duplicated,’ she added.
Howard Catton, RCN head of policy, added: ‘I think concentrating on polyclinics and what buildings might be used is missing the point. The debate we should be having is about how we transfer services from the acute sector into the community.’