Plans to build 152 doctors’ “super-surgeries” in England are confused and there is limited evidence that they will be effective, according to an expert in primary care.

Martin Roland, director of the National Primary Care Research and Development Centre at the University of Manchester, said that primary care trusts were already being required to develop polyclinics, or multi-doctor centres, but there was “little clarity about their purpose”.

Lord Darzi of Denham, the Health Minister, has yet to produce the final report of his NHS review, but the Department of Health has indicated that it expects all 152 primary care trusts in England to have at least one poly-clinic. Private companies will provide many of them, although the department has promised GPs that they will get a level playing field in tendering for the contracts.

Professor Roland wrote in the British Medical Journal that the Government champions patient choice, but extending choice means more high-quality practices, not fewer, as the polyclinic model suggests.

He said: “On average they [small practices] achieved slightly higher levels of clinical quality than the larger practices.”

Polyclinics may also have specialists working in them, but he claims that there is evidence that consultants work less efficiently outside hospitals.

Polls show that GPs are strongly opposed to polyclinics. Richard Vautrey, deputy chairman of the British Medical Association GPs’ committee, said: “This is a government plan that is potentially going to waste hundreds of millions of pounds of scarce NHS resources, creating very large health centres that many areas of the country don’t need or want.”

The medical newspaper Pulse has begun a campaign called Save Our Surgeries, and reported that polyclinics would force GP practices to close or merge, and patients to travel further.

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