Introduction to Primary Care Flashcards
Describe the structure of the NHS
Primary care: where illness first presents and most are managed. Has a Gatekeeper and preventative function. Mary refer to secondary or tertiary care.
Secondary care: hospitals consulting role. May refer back to primary care or onto tertiary care.
Tertiary care: specialist regional centres. May refer back to primary or secondary care.
Explain how the gap is bridged between primary and secondary care
Public health and occupational medicine specialists.
Hospital specialties eg palliative care, mental health
Long term condition management
Community hospitals
List the key statistics for primary care:
Proportion of all patient contact in NHS
How many patients per GP
Distribution of symptoms and consultations
How many patients are referred to secondary care
90%
1,700
79% self care, 20% GP, 1% hospital
3%
List some key facts about the work of GPs in primary care
Start and end point of most patient journeys
Provides key elements of continuity coverage and effective risk management
Self -employed in practices
Out of hours - GMed and NHS 24
Health and Social Care Partnerships
List common presenting undifferentiated and uncertain problems
Back pain Child sore throat/earcache/headache Anxiety/depression/other mental health problems Cough/breathlessness/wheezing Skin rashes Abdominal pain/vomiing/diahhorea TATT Chest pain Heart attacks and cancer related symptoms (uncommon but do occur)
Describe some of the things a GP might have to do in a day
Paperwork, telephone calls, surgery, house calls, duty dr, practice business or staff issues, BASICS, specialist interests, event coverage
Describe some of the problems a GP might encounter
Pressure to prescribe Worried well Ignoring advice Risky behaviour Ethical dilemmas: abortion, assisted dying, expensive drugs of little benefit, dealing with very elderly patients
List the primary care specialities
General Practice
Occupational Medicine
Public Health
Describe the roles of the following professionals in a healthcare team: GP Practice Nurse District Nurse Health Visitor Midwife Receptionist Medical Secretary Physiotherapist Occupational Therapist Dietician Social worker Pharmacist
GP - board or self employed. Routine healthcare delivery, referral to secondary care, mangement of LT conditions
PN - fully qualified nurse with additional training. Responsible for dressings, stitch removal, BP checks etc
DN - as above but works for health board and carries out above in homes in community. Attached to GP practice
HV - as above but focuses on prevention and promotion o health in under fives
Midwife - as above but own caseload of pregnant women entirely responsible for but leases with GP practice
Receptionist: employed by practice - filing, admin and telephone calls
Med Sec: may have sec training. Prepares correspondence etc
PT: graduate. Health board. Functional view. Uses physical treatments to enhance physical, psychological and social health.
OT: graduate. Health board. Helps those affected by diasability overcome the effects and promote wellbeing in all aspects of life
Dietician: graduate. Health board. Promotes and advises on nutrition
Social worker: graduate. Local authority/volunatry sector. Helps those affected by physical, psychological, social, addiction or offending problems restore social functioning, gives advice and offer practical help.
Pharmacist: graduate and further training. Health board or private. May work in pharmacy in Gp practice or provide advice to a group of pharmacies.
Describe what is meant by GPs being NHS gatekeepers
Control access to secondary care
List the advantages of GPs being gatekeepers
Identifies patients who need secondary assessment
Prevents inappropriate referal
Patients might not know which specialty to go to
Increases likelihood of appropriate referral
Increases likelihood of referal to appropriate department/investigation
Prevents unecessary exposure to certain procedures
GP can act as co-ordinator of care
GP can provide patient education
