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‘Polyclinics may lead to a fragmentation of care’

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Sometimes the cost of change can outweigh its benefits. Years ago I told my mother about shopping over the internet. She pointed out that I had to use a computer and internet connection to do what she’d done with a pen and paper 40 years before – when she dropped off her shopping list at the local grocer

Her main point was that I was a mere number to the supermarket. It was a valid point. I don’t mind being a number in the supermarket. But in healthcare, it’s different.
Healthcare is not a series of transactions, it’s about relationships, and GP practices form the bedrock of these relationships. I’ve been with the same practice for 25 years. When I signed on with the practice I thought I was immortal. My GP has provided support and care throughout the years as I’ve discovered that I am not immortal. I guess my medical records would say that I’m a mother of two and have thyroid and balance problems. But medical records don’t capture your personality – that’s why the relationship between a GP and a patient is so important. My GP sees me as a whole person and provides individualised care.
The proposals to reconfigure GP services in London may damage that relationship. It is true that the polyclinics may be able to offer more services – X-rays, bladder scans, Doppler scans, minor operations and possibly a host of other things. But will the benefits outweigh the costs? I’m not sure.
I fear the polyclinics will lead to a lack of continuity and fragmentation of care. Will general practice be reduced to a series of transactions? Will we move from a personalised corner shop model of care to a supermarket model where we’re all just numbers on a screen?
In my experience doctors who know their patients well make better clinical decisions, underpinned by that knowledge. People who are frail, vulnerable and have complex needs benefit most from this approach.
Doctors who do not know patients well, play it safe. This means that the patient may be subjected to inappropriate investigations and treatment. The personal touch is lost. The humanity that characterises general practice is replaced by the technical. I’m not sure that’s progress.
If polyclinics are to be introduced across London then this needs to be done with great care. We need to be really sure that the cost of this change does not outweigh its benefits.

Linda Nazarko is an independent nurse consultant
NEXT WEEK: Rob Harteveldt on the money wasted on people who miss appointments

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