Tony Davis, CEO of Medilink West Midlands, looks at how the Government’s plans for ‘polyclinics’ will impact on patients and health provision, and what opportunities they will create for the medical technologies sector.
On Saturday 16 February, the BBC announced: “One-stop clinics ‘are the future’... Clinics manned by a single doctor should be replaced by one-stop health shops run by several GPs, Health Minister Lord Darzi has told the BBC. So-called ‘polyclinics’, which house GPs alongside medical services normally offered at hospitals, are better suited to patients’ needs, Lord Darzi said.”
The Government has said it expects 150 polyclinics to be built across England. This represents a significant change in the infrastructure of healthcare provision. But what are the implications for industry?
Don’t get acute
Lord Darzi’s recent announcement on polyclinics confirms the Government’s intention to devolve as many services as possible to the community, taking the pressure off (and reducing the costs of) acute hospital services. This is a trend that Medilink West Midlands has been tracking on behalf of industry for the last couple of years, and which has impacted on the remote diagnostics and imaging initiatives of our own i
Over the last year, MedilinkWM has detected a definite policy push from the DH to devolve NHS services such as outpatients, imaging and minor operations to the domain of the GP surgery, along with a push to enable patients to monitor their own healthcare successfully. It’s a moot point whether this is being done on the basis of delivering a better quality of public healthcare or reducing the costly acute hospital budgets.
This shift has been highlighted in the West Midlands SHA’s document Investing for Health
, which clearly indicates the need for community-based healthcare and treatment to be delivered at home, and puts emphasis on self-help and people taking action to ensure they remain healthy. This implies greater delivery of medical treatment and specialist clinics through local GP services or polyclinics.
Opportunities for industry
Polyclinics and other devolved services will only be effective if the hospital can unbundle its products and technologies and then manage the communication between patient, polyclinic and hospital. This is a considerable challenge for the NHS, as changes in service delivery of this magnitude are generally disruptive if not tightly managed.
Lord Darzi has stated clearly that polyclinics will depend on GPs working together to provide a critical mass of service that will be able to deliver a new kind of experience to patients. GPs will also have a responsibility to liaise and report back to the acute service.
The NHS has struggled in the past with handovers and communication between departments within hospitals. Creating a service offering in multiple settings can only be achieved if the NHS works with industry to provide healthcare technology solutions.
The challenges that polyclinics present can provide multiple opportunities for technological solutions from industry – primarily in the fields of diagnostics, scanning, data handling, data storage, digital communications, software and hardware. Many companies who have provided technology or services that facilitate change in other sectors of the economy could potentially translate their offerings into this market.
There will also be changes in the way equipment is procured that should be factored in by industry. NHS procurement is already complex, with multiple access points for companies trying to sell into it. Now many minor operations and diagnostic procedures will be carried out in a PCT setting for the first time, and will have to be commissioned in the community.
Polyclinics and other devolved services will only be effective if the hospital can unbundle its products and technologies and then manage the communication between patient, polyclinic and hospital. This is a considerable challenge for the NHS.
There are also indications that with changes to NHS procurement such as commissioning and contracting out, some of these services may be provided by commercial entities. There are signs that patients will need to contribute towards their own healthcare, and some areas are now giving patients vouchers towards the price of assistive technology equipment.
Who will manage this procurement? Who will companies target with their marketing and sales campaigns: GPs, hospital clinicians or even patients?
What is a polyclinic? The polyclinics will be GP surgeries and other healthcare providers housed together in one building to provide a host of outpatient services. In other words, a one-stop shop for primary and community care, offering such services as:
• diabetes screening
• tissue viability
• leg ulcer clinics
Polyclinics may also perform many day case surgeries that do not require an overnight stay, such as:
• contraceptive procedures
• minor hernia operations
• bunion operations
• varicose vein stripping
• laparoscopic procedures.
The DH’s Day Surgery: Operational Guide calls for “Assessment of the patient’s home circumstances, and for certain types of surgery, access to the patient’s home.” It also states: “Patients should be encouraged to arrange for a carer to stay with them, or for them to stay with a carer, until they are able to be self-caring. Lack of social backup should seldom be a reason to exclude a patient from day surgery.”
This indicates potential opportunities for new patient monitoring technologies to link back to the polyclinic in order to ensure the patient’s wellbeing following day case surgery.
Lord Darzi’s previous report highlighted the need for the NHS to work with industry and use new technology to provide innovative solutions as a way to address cost barriers and ensure that patients’ needs are met.
Lord Darzi stated: “Effectiveness is not just about making use of the very latest treatments and technologies. It is also about ensuring that patients receive well co-ordinated and integrated care.
“Nationally, I believe we should focus on facilitating innovation and on creating a clear quality framework for healthcare.”
Watch this cyberspace
Continuing from our i
-Health project, over the next few years MedilinkWM will be trying to understand the way this new market opportunity is panning out – as well as pushing for answers on how equipment and services will be procured.
We envisage that there will be a growing provision of private services and products to monitor health and provide healthcare services. For example, Philips has recently dropped its consumer goods and will be concentrating on electronic healthcare, mainly for clinicians but also for the home market. We recently saw a set-top box it is developing for patients at home to access a variety of medical devices.
This is just the start. The polyclinics as they evolve will build their outreach and continuing care facilities through the use of electronic healthcare services, whether these are supplied by the NHS or social services or purchased directly by the patient. So look out for major telephone and Internet providers entering this market, and products appearing in your local superstores!Tony Davis is CEO for Medilink West Midlands. For more information on MedilinkWM and the
i-Health project, visit www.medilinkwm.co.uk.