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The DoH's demand for a new polyclinic in each PCT means a new one must be built even where one already exists.

This means that in Macclesfield, where all 44 of the town's GPs already work from a modern, £13 million building, another polyclinic must be built.

Central and Eastern Cheshire PCT is required to build another polyclinic, which will be situated little over a mile away.

Nicola Kent, primary care project manager at Central and Eastern Cheshire PCT, said that the DoH's operating framework required it to create another building to reduce A&E admissions.

'We have to provide something additional,' she said. 'We know there are problems with people inappropriately going to A&E so we will provide a walk-in service near the hospital.'

Macclesfield's Walters Green Medical Centre, which opened in 2006, is not dissimilar to the DoH's polyclinic model.

The huge building houses six GP practices that moved into the building with the financial assistance of Assura Medical Limited.

It is centrally located so patients across Macclesfield need only take one bus to get there.

But the GPs remain on PMS and GMS contracts and do not offer extended hours.

The PCT says a second polyclinic is necessary to provide walk-in facilities and improve access for the population. Like other PCTs across England, Central and Eastern Cheshire PCT will be funding the new centre from its general budget.

However, the PCT's performance report states that there are 'no issues of concern about access to a GP' in the area.

GP Dr Gill Plant, chairwoman of the board of GPs at Waters Green Medical Centre, said GPs were concerned about polyclinics and walk-in centres run by private providers.

'I can't imagine there are many GPs that are comfortable knowing a company is moving into their patch,' she said.

Dr Plant also felt uncomfortable offering walk-in services when pilot schemes had been inconclusive.

'It is hard to be enthusiastic about a service that isn't evidence based,' she added.

GPC negotiator Dr Peter Holden said: 'Many PCT chief executives don't need a new polyclinic but daren't speak out against it. Macclesfield has an excellent primary care set-up. This will be an expensive white elephant.'

tom.ireland@haymarket.com