title: Community nursing in systems reform: the London polyclinic experience.
abstract: Internationally, the polyclinic has been a feature of many health systems. The recent UK policy shift towards enhanced coordination of care closer to home resulted in the development of polyclinics, most notably in London. This article explores the background to the development of polyclinics and draws on the early experience of developments in London to explore what their impact has been, and is likely to be, on community nursing. Emerging findings from an evaluation of four pilot polyclinics suggests that rather than one model, polyclinics evolved in distinctively different ways more appropriately labelled as polysystems. Although policy makers clearly identified community nursing as being one of the key components of integrated, community-based care, the evaluation suggests a focus on high-level organizational restructuring and system change can shift attention from what many would consider core activities such as community health services.
authors.affiliation: Department of Health Service Research and Policy, London School of Hygiene & Tropical Medicine.
authors.forename: Stephen
authors.initials: S
authors.lastname: Peckham
authors.forename: Patricia
authors.initials: P
authors.lastname: Wilson
authors.forename: Jeni
authors.initials: J
authors.lastname: Gosling
authors.forename: Dorota
authors.initials: D
authors.lastname: Osipovic
authors.forename: Andrew
authors.initials: A
authors.lastname: Wallace
mesh_terms: D000554:Ambulatory Care Facilities; D003152:Community Health Nursing; D003153:Community Health Services; D018166:Health Care Reform; D006801:Humans; D008131:London; D011320:Primary Health Care; D013222:State Medicine; D006113:United Kingdom