The Case for Polyclinics: Closing the NHS Diagnostic Gap

2026 report argues the NHS patient flow crisis is driven by a diagnostic gap in primary care, and makes the economic case for a targeted pilot of community polyclinics in the most deprived areas.

Leeds, July 2026. A new Leeds Policy Institute (LPI) report argues that the NHS patient flow crisis stems less from rising demand than from a structural gap in diagnostic access at the primary care level, one that leaves Accident and Emergency as the default route for patients who need imaging and assessment rather than emergency care. Combining three linked economic models with a United Kingdom and Singapore comparison, the paper makes the case for polyclinics, larger integrated community health centres that bring together GP services, same-day diagnostics, and multidisciplinary teams.

Read the Full Report

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“Patients arrive at A&E not because their conditions are emergencies, but because it is the only place they can be assessed, imaged, and discharged within a single visit.”

Key Findings:

1. Transforming Infrastructure into a Multi-Benefit Platform. While the foundational infrastructure appraisal (Model A) is conservatively evaluated against Accident & Emergency deflection alone, this baseline creates a multi-use platform for the NHS. Because the core infrastructure costs are fully accounted for upfront, expanding operations to include wider clinical benefit streams requires zero incremental capital cost. This demonstrates that the initial capital investment effectively unlocks subsequent, highly profitable care streams that are completely ignored in a deflection-only appraisal.

   
   

2. Unlocking Tens of Millions in Chronic Disease Prevention. The Cost-Benefit Analysis proves that polyclinics can drastically reduce the long-term financial burden of chronic conditions, specifically Type 2 diabetes (Model B). By facilitating earlier detection and intervention, the care model becomes net-positive by Year 3, delivering an annual net NHS impact of £16.9 million. Over a ten-year horizon, this single disease pathway generates a £39.0 million cumulative discounted net benefit. A highly significant £17.0 million of the £18.5 million gross savings achieved in Year 1 stems directly from preventing severe, costly complications such as chronic kidney disease and the need for dialysis.

   
   

3. Delivering Immediate Screening and Productivity Returns. Utilising polyclinics for population screening (Model C) produces immense societal and financial value. The shift to rapid, point-of-care screening generates a positive annual net benefit of £1,149,678 per centre, which amounts to roughly £5.75 million per year across a five-centre programme. Over a five-year appraisal window, this screening and productivity model independently delivers a discounted Net Present Value of £25.95 million. Furthermore, delivering these screenings at a point-of-care unit cost of approximately £17.04 per person is actively cost-reducing when compared to conventional, slower laboratory pathways.

   
   

4. Demonstrating Unprecedented Economic Resilience. The projected value of the polyclinic screening model remains robust even under the most pessimistic assumptions. When tested against a severely conservative scenario—assuming a health gain of just 0.002 QALYs per patient, which is a mere one-twenty-fifth of the benefit observed in the comparable NHS Health Check programme—the model still reliably returns £4.01 million. This confirms that the polyclinic platform remains a secure, value-generating investment for the NHS that easily outweighs its initial cash costs.

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Policy Reccomendations:

1. Target the pilot using Core20PLUS5. Rather than distributing centres randomly, focus the five-centre pilot on the most deprived 20% of the population identified by NHS England's Core20PLUS5 framework, and evaluate it over five years against both A&E deflection and health inequalities metrics to build a dual economic and equity evidence base.

   
   

2. Position polyclinics as parallel provision, not displacement. Rather than cannibalising GP practices, polyclinics can absorb episodic, diagnostically driven demand while existing surgeries keep their registered lists and their role as the longitudinal point of care, staffed in part by the underused cohort of doctors stuck at the FY2 bottleneck.

   
   

3. Expand practitioner roles at a manageable pilot scale. Build the multidisciplinary model with GPs in a supervisory and complex-case role supported by advanced nurse practitioners, clinical pharmacists, physiotherapists, and on-site radiographers, raising capacity without a proportional rise in medical staffing costs. A five-centre pilot needs roughly 15 to 25 advanced nurse practitioners nationally in its first phase.

   
   

4. Deliver community engagement through existing infrastructure. Reach disengaged populations through voluntary sector organisations already embedded in deprived areas, such as food banks, community centres, faith organisations, and social prescribing link workers, and involve community representatives in pilot governance from the outset to rebuild trust with patients the NHS currently struggles to reach.

   
   

By reframing polyclinics as a diagnostic platform rather than a single-purpose deflection tool, this policy paper sets out how a carefully targeted pilot could ease pressure on A&E, bring chronic disease detection forward, and narrow health inequalities, giving the NHS an evidence base built on both economics and equity before any national rollout.

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About Leeds Policy Institute

Leeds Policy Institute (LPI) is the UK's first student-run policy unit and think tank based at the University of Leeds. Since its founding in April 2023, LPI has brought together over 100 undergraduate and postgraduate students across a wide range of disciplines to produce evidence-based, non-partisan research. All research outputs undergo rigorous internal review and are evaluated by the Academic Advisory Council. In its third year of operations, LPI members have presented at the British Conference of Undergraduate Research in London (LSE), Newcastle, and Glasgow, and have seen their work featured on national platforms including the Financial Times.

Media Contact:

Anatoly Safiulov

President, Leeds Policy Institute

+44 7849 891757

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Notes to Editors:

• The full policy paper is available upon request.

• The paper combines a model-based economic evaluation with a United Kingdom and Singapore comparative analysis and an implementation framework.

• The evaluation uses three linked models: an infrastructure cost-benefit analysis, a Type 2 diabetes early-detection budget impact model, and a screening and productivity cost-benefit analysis, discounted at 3.5% in line with Green Book guidance.

• The LPI is based at the University of Leeds and produces independent, evidence-led research to inform UK policy.