The idea of community-based medical centres that would be operated alongside traditional GP surgeries is being put forward by the doctors’ organisation, the British Medical Association in its response to the Government’s White Paper consultation “Your Health Your Care Your Say.” The centres would offer patients access to a new-style resource with diagnostic facilities, outreach specialist services and social services staff under one roof.The BMA submission says while GP practice-based care would be preserved for most patients, the proposed centres could also have other clinical services such as physiotherapy and dietetics. In addition they could offer information on health conditions and advice for patients on how to manage their illness. On the social care side there could be staff giving advice on employment and welfare benefits.
The BMA says it sees a key role for practice based commissioning in delivering these and other benefits and its response to the White paper continues, ” If properly implemented it could give groups of clinicians across sectors the ability to redesign services, establish more efficient care pathways, reduce referrals and offer patients a greater say and more choice in their journey through the system.”
It says planning the reorganisation of services would include not just family doctors but those working in secondary care and in public health roles. It envisages all clinicians who would be affected by this redesign of services being involved and says the transfer of work from hospitals to the community would need to be reflected in the training of junior doctors.
In its Executive Summary the BMA submission says: “The BMA sees considerable potential benefits for both patient and professionals in reforming care outside hospitals and in bringing more services currently provided in hospitals closer to the community. However, we also recognise that, to be most effective, many specialist services will have to remain in the hospital setting.”
The BMA adds that it recognises access to primary care services is a real concern that needs to be improved in some parts of the country. Possible solutions already being explored with NHS Employers include patients being allowed to register with a home practice and one near their workplace. The submission says, “Any dual registration arrangement must not be allowed to diminish the registered list system but it shares the public’s desire to have more convenient access to a GP or health care professional.