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Delivering primary care.

  • Last modified date:
    18 May 2007
GP treating patient

Primary care describes community based health services that are usually the first, and often the only, point of contact that patients make with the health service. It covers services provided by family doctors (GPs), community and practice nurses, community therapists (such as physiotherapists and occupational therapists), community pharmacists, optometrists, dentists and midwives.

Primary care trusts

Primary care trusts (PCTs) are at the centre of the modernisation of the NHS and are responsible for 80 percent of the total NHS budget. They are free-standing NHS organisation with their own boards, staff and budgets. PCTs are monitored by their local SHA and are ultimately accountable to the Secretary of State for Health. They work with other health and social care organisations and local authorities to make sure that the community's needs are met. PCTs provide some care directly and commission services from others, such as NHS acute trusts and private providers, with decisions on providers increasingly informed by the choices which patients make themselves.

PCTs are responsible for:

  • developing programmes dedicated to improving the health of the local community
  • deciding what health services the local population needs and ensuring they are provided and are as accessible as possible. This includes hospital care, mental health services, GP practices, screening programmes, patient transport, NHS dentists, pharmacies and opticians
  • bringing together health and social care, so that NHS organisations work with local authorities, social services, and voluntary organisations
  • ensuring the development of staff skills, capital investment in buildings, equipment and IT, so that the NHS locally is improved and modernised and can continually deliver better services.

Every PCT is committed to achieving the maximum health improvement through prevention and other interventions. This can include everything from ensuring that smoking cessation services are achieving high long-term 'quit' rates to ensuring that the primary care element of the targets of national service frameworks are met.

Primary care services

Patient and receptionist at walk-in centre

The main providers of primary care are general practitioners, dentists, opticians, pharmacists, NHS walk-in centres, NHS Direct and care trusts. Primary care services can be accessed through a number of different ways.

  • General practitioners (GPs) work with nurses and other staff to treat patients for a range of health problems. They also give health education and advice, run clinics, give vaccinations and carry out simple surgical operations. Every UK citizen has a right to register with a local doctor's surgery and visits to surgeries are free.
  • Dental care is provided by dentists, who provide check-ups, carry out treatments, and play a key role in improving dental health. Dental practices can take private and NHS patients.
  • Ophthalmic medical practitioners and optometrists provide eye services to the general public. This includes treating diseases and abnormalities of the eyes, providing eye tests and dispensing prescription glasses.
  • Pharmacists are responsible for supplying medicines for patients and members of the public either through a doctor's prescription or through general sale, usually from high street chemists.
  • NHS walk-in centres throughout England offer fast and free access to health advice and treatment at convenient times and locations. Their services include treatment for minor illnesses and injuries, assessment by an experienced NHS nurse, advice on how to stay healthy and information on local health services.
  • NHS Direct is a telephone line, staffed by nurses, which provides fast and free 24-hour health care advice. This ranges from advice and support on self-treatment to details about appropriate further services.
  • Care trusts combine the provision of health and social care services for different client groups through better integration. By combining both NHS and local authority health responsibilities under a single management, care trusts can increase continuity of care and simplify the administrative process.

Commissioning

In future, GPs and other primary care providers will have more power to commission local health care services that respond to the needs of their patients. This includes directing funds into care for indivdual patients with long term conditions. Patients not only benefit from a wider choice of services, but also from services that are closer to their homes.

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