Polyclinics and psychiatry

The preliminary review of the National Health Service (NHS) in England, led by Lord Darzi, proposed the development of ‘polyclinics’, which in the final report are referred to as ‘GP-led health centres’. Although there is considerable confusion in the literature about what it actually means, the term polyclinic will be familiar to those who have worked in the former Soviet countries of Europe (e.g. Russia and the Ukraine), where the institution called a polyclinic was essentially an out-patient unit staffed by specialists supported by lower-status doctors. Attempts in recent health reforms in those countries to introduce a tier of vocationally trained general practitioners (GPs) into such settings were met with some resistance, not least from specialists. However, polyclinics, once limited to the old East Germany, are now opening across Germany and this newer model of polyclinic, promoted within the UK as early as 1920, brings together primary care, specialists, diagnostic and therapeutic services under one roof, thus creating a large, extended, multiprofessional, out-patient clinic.