Polyclinics and public health: The lessons from (and for) England

The National Health Service (NHS) in the United Kingdom has a long history of primary medical care with the General Medial Practitioner (GP) and their registered patients. Over the sixty years of the NHS’s existence we have seen a shift from the single operating GP  towards groups of GPs, part of whom operating in ‘health centres’, as a  base for also the providers of the wider primary care: public health nurses, occupational therapists, physiotherapists etc.  It is now proposed to create a network of polyclinics which would extend substantially the range of health services provided outside the acute hospital setting.
The purpose of this paper is to set out the lessons learnt for public health from the development of health centres and explore the potential for a new era of polyclinics in England. We analyse the development of health centres in the NHS in England and draw on the published literature dealing with a number of farsighted experiments that combined the provision of primary medical care with a wide-reaching vision of delivering public health improvement. We explore the proposal to create networks of polyclinics in England is and the parallels with the international experience of polyclinics.
We outline the recent lessened engagement of hospital-based clinicians in public health; analysing, in particular, their past engagement smoking and seatbelts.  Finally, we examine the potential for a new engagement between polyclinic-based services and the public health needs of the community.