UK Primary Care from BMJ Learning

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• published: 13 May 2014
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http://learning.bmj.com This short film demonstrates the primary care model used in the UK's NHS. http://learning.bmj.com Partial Transcript Good primary care is the main reason that makes the UK NHS one of the most efficient health systems in the world. Led by General Practitioners, or GPs primary-care teams work in general practice clinics which are also called surgeries. They provide comprehensive, continuous and holistic care to patients. The vast majority patient contacts are made by appointments. Good afternoon, Ley Hill Surgery. Hello, I'd like to book an appointment please. Appointments can be made by phone, as in the case here, by appearing in person, or over the internet. Lovely, 3:30 today, Dr. Huang. Okay, thanks see you later. My typical day starts, I would say, a quarter to 8. I get here at a quarter to 8 and I'll start leaving for home about quarter to 7. So between that time, broadly speaking, I run two clinics: one morning, one afternoon, with home visits during the day and administrative work. Ley Hill Surgery is testing the automatic messaging system to see if this reduces non-attendance rates. This has generally been well-received by patients but it is too early as yet to know if this is having a significant impact on reduction of non-attendance. For each of our clinics, morning and afternoon, I probably see about seventeen patients. These are booked appointments. I'll do a couple of home visits, on average, and then there will be lots and lots of administrative work to catch up with. Correspondence from secondary care colleagues, results to review, letters from patients or phone calls to return. And also management work to do with running of the practice. The practice maintains records of all patients from birth to death. The bank of files here of the older paper records used prior to the records going fully electronic in the year 2000 at the practice. In the UK, patients have to register with a general practice near their homes and they cannot go to hospital directly for care without referral from the GPs. This is why we often call GPs gatekeepers of the health system. I see patients of all age groups from children right through to old age. In fact, I'd say that only a small minority of children end up seeing hospital pediatricians. Only a small number all mentally ill patients ever see a psychiatrist. The great bulk of medical conditions are dealt with here in general practice. We are the gatekeepers, we sort everything and only refer problems as required for help by second care colleagues. These pictures introduced some of the key personnel at the practice. They include doctors, nurses and administration staff. The task of delivering healthcare involves a range of skills working closely in a team. There are a number of factors behind the success of of British General Practice. As a medical specialty, General Practice has its origin in the UK. It therefore has a long history and has been a main feature of the system since the inception of the NHS in 1948. GPs are very popular among the public. They enjoy a high status in the medical profession. Good income, at such that the disparity between GP income and specialists income is minimal. So that stops being the reason why people choose whether they're going to become a GP or specialist. In fact, some of the best medical students, the best graduates, choose General Practice as their future careers The practice is an undergraduate and postgraduate training practice and commonly has medical students and trainee general practitioners seeing patients. patients understand this and are usually happy to play their part in medical education. I chose General Practice for my career because I like the idea of being more of a generalist. So when you're in a hospital specialty you kind of stick to one area whereas I like the fact that GPs need a breadth of knowledge and they get loads of experience in different areas. I also like the relationship that you built with patients and also their families. The whole concept of being a family doctor and having a bit more of holistic approach to health care is also really appealing to me. And also I really like the flexibility that GP brings with it. So it's quite family-friendly in terms of working hours and everything else so, I think those are the main reasons why I chose GP as my career. These young doctors then receive rigorous and systematic training for several years. Therefore the overall quality of our GPs is improving all the time. Notice that there is no cash till. The NHS is a free to access service and patients do not pay at the point of use. There are consultation rooms around the waiting room. And to ensure privacy and confidentiality for patients the speaker plays background music to prevent any possibility of the consultations being overheard.