Skip to main content
×
×
Home

Polyclinics and psychiatry: risks and opportunities

  • Linda Gask (a1), Suresh Joseph (a2) and Michele Hampson (a3)
Summary

The arrival of the ‘polyclinic’ or ‘GP-led health centre’ has been signalled in the review of the National Health Service. A variety of options have been proposed for the way in which polyclinics will incorporate specialist services to work alongside primary care, and the relevance of these models to mental healthcare is considered. Polyclinics provide new opportunities but with those possibilities come potential threats and risks. Of key importance is the threat that they will re-institutionalise mental healthcare after many years of breaking down such barriers. Buildings provide shared space, but new working practices are more difficult to achieve.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Polyclinics and psychiatry: risks and opportunities
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Polyclinics and psychiatry: risks and opportunities
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Polyclinics and psychiatry: risks and opportunities
      Available formats
      ×
Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Linda Gask (Linda.Gask@manchester.ac.uk)
Footnotes
Hide All

Declaration of interest

None.

Footnotes
References
Hide All
1 Imison, C, Naylor, C, Maybin, J. Under One Roof: Will Polyclinics Deliver Integrated Care? King's Fund, 2008.
2 Department of Health. High Quality Care for All: NHS Next Stage Review Final Report. Department of Health, 2008.
3 Finch, R. When is a polyclinic not a polyclinic? BMJ 2008; 336: 916–8.
4 Rese, A, Balabanova, D, Danishevski, K, McKee, M, Sheaff, R. Implementing general practice in Russia: getting beyond the first steps. BMJ 2005; 331: 204–7.
5 Healy, J, McKee, M. Health sector reform in central and eastern Europe: the professional dimension. Health Policy Plan 1997; 2: 286–95.
6 NHS Evidence – Health Management. Polyclinics. NHS Evidence, 2009 (http://www.library.nhs.uk/HealthManagement/ViewResource.aspx?resID=267332).
7 Ministry of Health, Consultative Council on Medical and Allied Services. Interim Report on the Future of Medical and Allied Services. HMSO, 1920 (http://www.sochealth.co.uk/history/Dawson.htm).
8 Alford, S. Polyclinics to replace traditional doctors' surgeries. Sunday Times, 2008; 16 February (http://www.timesonline.co.uk/tol/news/uk/health/article3380852.ece).
9 The Health and Social Care Information Centre. Mental Health Bulletin: Second Report on Experimental Statistics from Mental Health Minimum Dataset (MHMDS) Annual Returns, 2003–2008. The Health and Social Care Information Centre, 2009.
10 Boardman, J, Henshaw, C, Willmott, S. Needs for mental health treatment among general practice attenders. Br J Psychiatry 2004; 185: 318–27.
11 Kilbourne, AM, Schulberg, HC, Post, EP, Rollman, BL, Belnap, BH, Pincus, HA. Translating evidence-based depression management services to community-based primary care practices. Milbank Q 2004; 82: 631–59.
12 Sibbald, B, MacDonald, R, Roland, M. Shifting care from hospitals to the community: a review of the evidence on quality and efficiency. J Health Serv Res Policy 2007; 12: 110–7.
13 Gask, L, Sibbald, B, Creed, F. Evaluating models of working at the interface between mental health services and primary care. Br J Psychiatry 1997; 170: 611.
14 Bower, P, Gilbody, S. Managing common mental health disorders in primary care: conceptual models and evidence base. BMJ 2005; 330: 839–42.
15 Leese, B, Bohan, M, Gemmell, I, Hinder, S, Mead, N, Pickard, S, et al. Evaluation of ‘Closer to Home’ Demonstration Sites: Final Report. National Primary Care Research and Development Centre, 2007.
16 Gournay, K, Brooking, J. Community psychiatric nurses in primary health care. Br J Psychiatry 1994; 165: 231–8.
17 Kendrick, T, Simons, L, Mynors-Wallis, L, Gray, A, Lathlean, J, Pickering, R, et al. Cost-effectiveness of referral for generic care or problem-solving treatment from community mental health nurses, compared with usual general practitioner care for common mental disorders. Randomised controlled trial. Br J Psychiatry 2006; 189: 50–9.
18 Department of Health. National Service Framework for Mental Health: Modern Standards and Service Models. Department of Health, 1999.
19 Bower, P, Sibbald, B. Systematic review of the effect of on-site mental health professionals on the clinical behaviour of general practitioners. BMJ 2000; 320: 614–7.
20 Chew-Graham, C, Slade, M, Montana, C, Stewart, M, Gask, L. Loss of doctor-to-doctor communication: lessons from the reconfiguration of mental health services in England. J Health Serv Res Policy 2008; 13: 612.
21 Gilbody, S, Bower, P, Fletcher, J, Richards, DA, Sutton, A. Collaborative care for depression: a systematic review and cumulative meta-analysis. Arch Intern Med 2006; 166: 2314–21.
22 Gask, L. Role of specialists in common chronic diseases. BMJ 2005; 330: 651–3.
23 Richards, DA, Lovell, K, Gilbody, S, Gask, L, Torgerson, D, Barkham, M, et al. Collaborative care for depression in UK primary care: a randomised controlled trial. Psychol Med 2008; 38: 279–87.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Bulletin
  • ISSN: 1758-3209
  • EISSN: 1758-3217
  • URL: /core/journals/bjpsych-bulletin
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 1 *
Loading metrics...

Abstract views

Total abstract views: 5 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 19th July 2018. This data will be updated every 24 hours.

Polyclinics and psychiatry: risks and opportunities

  • Linda Gask (a1), Suresh Joseph (a2) and Michele Hampson (a3)
Submit a response

eLetters

Polyclinics as hubs for delivering primary care mental health services

Safiullah Afghan, Consultant Psychiatrist, Walsall
23 March 2010

Whilst no one will disagree with the assertion that the proposed polyclinics will provide with range of opportunities which may include service integration, community engagement, social interaction and further education and learning, it is also important to give some practical suggestions and ideas towards that end.

Polyclinics can become hubs of community engagement, mental health public education and promotion if some of the activities highlighted beloware commissioned based on the specific needs and demands of local community.

a)Provision of proactive public education and awareness events including hosting of self help groups for common mental disorders especially for marginalized and hard to reach segments of population. Thiswill also be relevant for areas having distinct black, minority and ethnic (BME)and asylum seeking population as they are unable to seamlessly access care. The Community Development Workers can play an important role in coordinating these initiatives with the help of clinicians, voluntary agency workers.

b)Provision of group based psychological and social therapies, and other brief therapies (e.g. problem solving, supportive and post abuse counselling.

c)Broad services for young people and their families encompassing education, learning and therapeutic activities with regards to substance misuse, psychosis (in remission) and those with history of non serious offending.

d)Providing educational and vocational advice and training to mentalhealth service users as which could be run through shared funding and support by social care and third sector

The future of Mental Health: a vision for 2015 (2006) gives some useful examples. It states “by 2015, mental wellbeing will be the concern of all public services”. It also anticipates that future mental health services will be integrated into mainstream community locations such as libraries, GP surgeries and schools.

It is worth reminding that the agenda of public mental health as visibly enshrined in the New Horizons (2009) cannot be achieved without combating discrimination, still prevalent not only in public but even within health services & professionals and the initiatives such as above can serve a useful purpose.

Dr Safiullah AfghanPublic Education Officer, West Midlands DivisionConsultant Psychiatrist, Walsall

References:The Future of Mental Health: A vision for 2015, Sainsbury Centre for Mental Health (2006)New Horizons: Working together for better Mental Health, Department of Health (2009)
... More

Conflict of interest: None Declared

Write a reply

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *