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Developing Polyclinics in Waltham Forest

October 2008

Alison GoodladHead of Primary Care

Commissioning and Development

ORGANISATIONAL MODEL:Drivers

Recent investment

in new buildings

Good quality GPs

Momentum of change in General Practice

Movement of care

outside of hospital

ORGANISATIONAL MODEL:Polyclinic Facilities

70% infrastructure in place to deliver Polyclinics

Waltham Forest ready to move forward with new build/refurbished centres

Waltham Forest ready to move forward with centres in each locality

ORGANISATIONAL MODEL:Drivers- Providing more care outside hospital

Increase the number of

diagnostic tests done directly by

Primary Care

8859 diagnostic 8859 diagnostic tests in the tests in the communitycommunity

Increase the number of OPD

consultations done by Primary Care

41000 OPD 41000 OPD consultationsconsultations

Community Specialist Services introduced in 2008/09:

• Anticoagulation• Community Cardiology Service• Carpal Tunnel Service• Colorectal Clinic• Community Dermatology• Community Diabetes• Direct Access Physiotherapy• Direct Access Gastroenterology • Community based Musculoskeletal Pain Service• Community Specialist Urology Service

ORGANISATIONAL MODEL:Networked Polyclinic model

Polyclinic PROVIDE

R

HUB PRACTIC

E

Polyclinic PROVIDE

R

HUB PRACTIC

E

HUB PRACTIC

E

GPLHC

HUB PRACTIC

E

SPOKE PRACTIC

E

SPOKE PRACTIC

E

SPOKE PRACTIC

E

SPOKE PRACTIC

E

SPOKE PRACTIC

E

SPOKE PRACTIC

E

SPOKE PRACTIC

E

SPOKE PRACTIC

E

SPOKE PRACTIC

E

SPOKE PRACTIC

E

SPOKE PRACTIC

E

ORGANISATIONAL MODEL:Networked Polyclinic model

Example of the hub and spoke model in Leyton/Leytonstone

Network Agreement:

• This outlines the principles and rules by which the network will function

• Patients should be referred to polyclinic services where clinically appropriate, in line with patient pathways unless the patient has requested to go elsewhere.

• Patients may be referred to any of the polyclinics

• Practices in the hub must not proactively seek to encourage patients registered with the spokes to switch registration.

ORGANISATIONAL MODEL:Stakeholder Engagement

GP and Stakeholder engagement – six

workshops held so far

Three Public events were held in July

GP & Stakeholder Event:

Key Concerns:• The hub will pull patients from the spokes

• Anxiety around the possibility of the private sector managing GPLHC

Services GPs would like to see in a polyclinic:

1. Diagnostics

2. Health Promotion

Health Visiting

3. Out-Patient Services

Counselling

Public Engagement:Getting patient’s views on Polyclinics / GP Led Health Centres

Services patients wanted to access:• Tests (i.e. blood tests, x-rays)• Urgent Care• Outpatient Clinics

Preferred hours for accessing services outside the working day:• Evenings• Saturday Mornings• Early Mornings

Important factors to access Polyclinics:• Transport Links• Parking

SERVICE MODEL

Tender for combined GPLHC and polyclinic and up to three stand-alone polyclinics

Contract will be for leadership and management of

polyclinics

Focus on integration of services and front

of house

Movement of care outside of hospital

Polyclinic Tender Process:Bidders to choose the location

• Bidders can choose from a number of potential locations indentified by the PCT

• There are nine options in total

ADVANTAGES:• Sensitivity of where the polyclinics will be located• Decisions will be made as part of the evaluation of the Tender

DISADVANTAGES:• Planning can be made difficult by not knowing the location of the clinics until the outcome of the tender is known

PROJECT STRUCTURE:Long Term plan

1st Polyclinic / GPLHC goes live in early part

of 2009/10

2nd Polyclinic goes live in latter part of

2009/10

3rd Polyclinic (Chingford) goes live

2010/11