Dr Tom Coffey: Why I'm in favour of the new scheme

GP with 14 years' experience in Wandsworth, south London

In most GP practices the buildings are crumbling and need improving. Our ability to access diagnostics such as X-rays and blood tests can also be limited, so we have to refer patients to hospitals for quite simple tests.

A lot of patients want better access to their GP, especially unscheduled care at evenings and weekends. But it's very hard for individual small practices to run surgeries 12 hours a day, seven days a week.

The care of people with long-term conditions requires a team approach. You need specialist nurses, GPs and consultants, and it needs to be a team of a sufficient size.

I'm in favour of a federated polyclinic approach, a hub-and-spoke model, because patients usually like their GP and like the fact they can walk there. But they also want better access and to see their GP out of hours as well as a team coordinating their care, so they need access to the "hub" which is the polyclinic. But they keep the "spokes", which are the local GP practices embedded in the community.

This approach allows you to have the best of both worlds. You keep your local GP practices while the hub handles diagnostics and unscheduled calls and forms a base for a team of specialists, where people can access GPs, mental health services and housing advice.

No GP, not even me, would support a single polyclinic site where all the GP practices for an area are based. You need the spokes in the community.

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