language-icon Old Web
English
Sign In

General practice

General practice is the name given in various nations, such as the United Kingdom, Australia and New Zealand, to the services provided by General practitioners. In some nations, such as the USA, similar services may be described as family medicine or primary care. The term Primary Care in the UK may also include services provided by community pharmacy, optometrist, dental surgery and community hearing care providers. The balance of care between primary care and secondary care - which usually refers to hospital based services - varies from place to place, and with time. In many countries there are initiatives to move services out of hospitals into the community, in the expectation that this will save money and be more convenient. General practice is the name given in various nations, such as the United Kingdom, Australia and New Zealand, to the services provided by General practitioners. In some nations, such as the USA, similar services may be described as family medicine or primary care. The term Primary Care in the UK may also include services provided by community pharmacy, optometrist, dental surgery and community hearing care providers. The balance of care between primary care and secondary care - which usually refers to hospital based services - varies from place to place, and with time. In many countries there are initiatives to move services out of hospitals into the community, in the expectation that this will save money and be more convenient. A group of 15 doctors based in Birmingham have set up a social enterprise company - Pathfinder Healthcare - which plans to build eight primary health centres in India on the British model of general practice. According to Dr Niti Pall, primary health care is very poorly developed in India. These centres will be run commercially. Patients will be charged 200 to 300 Rupees for an initial consultation, and prescribed only generic drugs, dispensed from attached pharmacies. In Ireland there are about 2,500 General Practitioners working in group practices, primary care centres, single practices and health centres. General Practice services in Australia are funded under the Medicare Benefits Scheme (MBS) which is a public health insurance scheme. Australians need a referral from the GP to be able to access specialist care. Most general practitioners work in a general practitioner practice (GPP) with other GPs supported by practice nurses and administrative staff. There is a move to incorporate other health professionals such as pharmacists in to general practice to provide an integrated multidisciplinary healthcare team to deliver primary care. The pattern of services in the UK was largely established by the National Insurance Act 1911 which established the list system which came from the friendly societies across the country. Every patient was entitled to be on the list, or panel of a general practitioner. In 1911 that only applied to those who paid National insurance contributions. In 1938 43% of the adult population was covered by a panel doctor. When the National Health Service was established in 1948 this extended to the whole population. The practice would be responsible for the patient record which was kept in a 'Lloyd George envelope' and would be transferred if necessary to another practice if the patient changed practice. In the UK, unlike many other countries, patients do not normally have direct access to hospital consultants and the GP controls access to secondary care. Services are provided under the General Medical Services Contract, which is regularly revised. In 1953, general practitioners were estimated to be making between 12 and 30 home visits each day and seeing between 15 and 50 patients in their surgeries. In 2019 according to NHS England, almost 90% of salaried GPs were working part time. Practices were generally small, often single handed, operating from the doctor's home and often with the doctor's wife acting as a receptionist. When the NHS was established in 1948 there were plans for the building of health centres, but few were built. The British Medical Association in 2019 conducted a survey for GP premises. About half of the 1,011 respondents thought their surgeries were not suitable for present needs, and 78% said they would not be able to handle expected future demands. The GP Forward View, published by NHS England in 2016 promised £2.4 billion (14%) real-terms increase in the budget for general practice. Jeremy Hunt pledged to increase the number of doctors working in general practice by 5,000. There are 3,250 trainee places available in 2017. The GP Career Plus scheme is intended to retain GPs aged over 55 in the profession by providing flexible roles such as providing cover, carrying out specific work such as managing long-term conditions, or doing home visits. In July Simon Stevens announced a programme designed to recruit around 2,000 GPs from the EU and possibly New Zealand and Australia. According to NHS Improvement a 1% deterioration in access to general practice can produce a 10% deterioration in emergency department figures.

[ "Family medicine", "Diabetes mellitus", "Pathology", "Nursing", "GP partner", "General medical services", "General practice surgery", "prescription event monitoring", "General/family practice" ]
Parent Topic
Child Topic
    No Parent Topic