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Moving GPs into polyclinics could worsen access, increase costs and damage care, according to an influential think tank.

The King's Fund report, 'Under One Roof: will polyclinics deliver integrated care?', says that there are 'compelling arguments' for providing integrated health services closer to patients' homes.

But it warns that there is no evidence that larger GP practices provide better services, and argues that 'a major centralisation of primary care is unlikely to be beneficial to patients'.

The report calls for PCTs to abandon plans to concentrate GP services into larger sites. Instead they should pilot several models, such as hub-and-spoke and 'virtual' polyclinics, it says.

Dr Niall Dickson, the King's Fund's chief executive, called for ministers to spell out 'in unequivocal terms' that PCTs will not be forced to build the new centres.

The report examines polyclinics abroad, as well as health centres built under Local Improvement Finance Trusts.

It argues that the planned reforms will not improve services without clinician support.

Other experts have echoed the report's suggestion that policy should focus on redesigning services, instead of just moving them to new buildings.

Professor Martin Roland, director of the National Primary Care Research and Development Centre, said at an event hosted by the think tank Civitas last week that polyclinics risked becoming an 'expensive exercise in building new buildings without clear thought about what they would do'.

GPC chairman Dr Laurence Buckman said: 'The report provides scientific, logical and international evidence that polyclinics won't deliver the things the government believes they will.'

But he added: 'This government doesn't listen to evidence.'

A DoH spokesman said it was not policy to impose polyclinics outside London.

jonn.elledge@haymarket.com

Kings Fund report

Polyclinic risks

• Benefits of co-location not realised because of poor planning.
• Access to GP services damaged in rural areas.
• Potential increase in costs.
• Co-location does not mean more co-operation.
  Source: King's Fund.

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