What is General Practice
Contents
Did You Know?
Definition of a
GP
Characteristics of a
GP
How are GP
Services Organised?
Life
as a GP
Did You Know?
- GPs refer 14% of the population to
hospital specialties, meaning that 86% of all health needs are
managed within primary care.
- Over 250 million consultations
take place annually in general practice, with 15% of the population
seeing a GP in any two week period.
- Around 42,000 GPs work in 10,500
surgeries in the UK. There are more GPs than all consultants in all
specialties combined.
- The average patient will visit
their GP about four times a year, with 78% of people consulting
their GP at least once during each year.
- Each GP looks after around 2,000
patients on average, and will conduct about 7,000 consultations per
year.
- About 40% of the GP workforce in
England is female compared to 25% ten years ago.
- About a quarter of all practices
in the UK are single-handed (one GP).
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Definition of a
GP*
General practitioners (GPs) are best defined by the unique
nature of the doctor-patient relationship. GPs are personal
doctors, primarily responsible for the provision of comprehensive
and continuing medical care to patients irrespective of age, sex
and illness. In negotiating management plans with patients they
take account of physical, psychological, social, and cultural
factors, using the knowledge and trust engendered by a familiarity
with past care. They also recognise a professional responsibility
to their community.
GPs exercise their professional role by promoting health,
preventing disease and providing cure, care or palliation. This is
done either directly, or through the services of others according
to health needs and the resources available within the community
they serve.
*Based on the RCGP-endorsed European
Definition of General Practice. For further
detail on the role of the GP see GP
Services and Fees section.
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Characteristics of a GP**
First Point of
Contact
GPs are normally the point of first medical
contact within the healthcare system, providing open and unlimited
access (during core hours) to all types of patients and health
problems.
Coordinate
Care
GPs coordinate care by working
with other professionals in the primary care setting, and by
managing the interface with other specialties, taking
an advocacy role for the patient when needed. This coordinating
role is key to ensuring that patients see the most appropriate
healthcare professional.
Person-Centred
Approach
GPs identify people and their
problems in the context of their life circumstances, developing a
person-centred approach orientated to the individual, his/her
family, and their community. In addition to dealing with the
disease process a good GP understands how the patient copes with
and views their illness.
Unique Consultation
Process
GPs have a unique consultation
process, which establishes a relationship over time, through
effective communication between doctor and patient. Each contact
between the patient and their family doctor contributes to an
evolving story, and each individual consultation can draw on this
prior shared experience. The value of this relationship is
determined by the communication skills of the family doctor can be
therapeutic in itself.
Continuity of
Care
GPs provide "longitudinal"
continuity of care, meaning that care is provided by
as few professionals as possible, and is consistent with other
needs. The general practice patient record provides a
narrative of the health and care of a
patient throughout the whole of their life. It is the task of
family doctors to be responsible for providing direct care to their
patients during core hours, or commissioning and co-ordinating care
when they are unable to provide it personally.
Multiple
Illnesses
GPs simultaneously manage both
acute and chronic health problems of individual patients. The
patient often consults for several complaints at the same time, the
number increasing with age. The doctor has to manage multiple and
complex problems by setting and negotiating priorities with the
patient.
Diagnostic
Uncertainty
GPs manage "undifferentiated" or
imprecise symptoms often at early stages in the development of
an illness. This means that important decisions for patients have
to be taken on the basis of limited information, with early signs
of disease often non-specific to a particular condition. Having
excluded an immediately serious outcome, the decision may well be
to await further developments and review later. Frequently the job
of the family doctor is to reassure those with understandable
anxieties about illness – having first determined that such illness
is not present.
How are GP
Services Organised?
The National Health Service
(NHS) is a "free at point-of-care" provider of general
and specialist healthcare, available to the entire population.
Central Government leads, funds and supports the NHS through
the Departments of Health in the UK.
Every UK citizen has a
right to be registered with a local GP and visits to the surgery
are free. GPs look after the health of people in their local
community and deal with a wide range of health and
social problems. They and their teams also provide health
education and advice on things like smoking and diet, run clinics,
give vaccinations, and carry out simple surgical operations. GPs
also visit patients at home where clinically necessary.
Each practice has a
contractual agreement with the local Primary Care Organisation
(PCO), outlining what services they must provide. PCOs are
responsible for the overall provision of primary care in their
local area.
New GP contracts (introduced in
2004) have given practice teams more freedom to
develop services that match the needs of their local population. If
there is a high incidence of heart disease, for instance, practices
may choose to invest in a GP or nurse with specialist knowledge of
that condition. The contract also rewards the quality (rather than
quantity) of clinical care for the first time.
GPs generally own their own
premises and directly employ practice staff such as
nurses and administrative staff. GPs can work on their own or
in partnership with other practitioners. They usually work in a
large team including nurses, health visitors and midwives, as
well as a range of other health professionals such as
physiotherapists and occupational therapists. Practices are
offering an increasingly wide range of services and treatments –
including tests to diagnose conditions like coronary heart failure
and lung problems.
If a GP cannot deal with a
problem themselves, they will usually refer a patient to
hospital for tests, treatment or to see a consultant with
specialised knowledge.
Further Information Resources
An NHS
fact sheet – available in 32
languages - explains the role of GPs within the NHS, including
how to register and how to access emergency services. For a more
in-depth overview of general practice and the NHS use the
links below:
So You Want to Be a GP? outlines life
as a GP through the eyes of former Chairman of the RCGP
Professor David Haslam. The document covers training; a snapshot of
daily life; the different types of general practice in the UK; and
pay.
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