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General practice

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290: 34: 222: 465:'s app, was launched in November 2017 by the Lillie Road Health Centre, a conventional GP practice in west London. It recruited 7000 new patients in its first month, of which 89.6% were between 20 and 45 years old. The service was widely criticised by GPs for cherry picking. Patients with long term medical conditions or who might need home visits were actively discouraged from joining the service. 388:'s Clinical Pharmacists in General Practice programme. There are also moves to employ care navigators, sometimes an enhanced role for a receptionist, to direct patients to different services such as pharmacy and physiotherapy if a doctor is not needed. In September 2017 270 trained care navigators covering 64,000 patients had been employed across 176:, 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. In many countries there are initiatives to move services out of hospitals into the community, in the expectation that this will be cost-effective and be more convenient. 368:
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
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reforms to allow new entrants, including commercial companies, to operate one or more general practices, named Alternative Provider Medical Services. Research in 2015 found that 4% of general practices were being run under these new arrangements, but they had not made improvements in the quality of
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599 GP practices closed between 2010–11 and 2014–15, while 91 opened and average practice list size increased from 6,610 to 7,171. In 2016 there were 7,613 practices in England, 958 in Scotland, 454 in Wales and 349 in Northern Ireland. There were 7435 practices in England and the average practice
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between 2014 and 2017 the number of telephone and face-to-face contacts between patients and GPs rose by 7.5% although GP numbers have stagnated. The mean consultation length in the UK has increased steadily over time from around 5 minutes in the 1950s to around 9·22 minutes in 2013–2014. This is
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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, supported by
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The proportion of patients in England waiting longer than seven days to see a GP rose from 12.8% in 2012 to 20% in 2017. There were 307 million GP appointments, about a million each working day, with more on Mondays, in the year from November 2017. 40% got a same-day appointment. 2.8 million
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85% of patients rate their overall experience of primary care as good in 2016, but practices run by limited companies operating on APMS contracts (a small minority) performed worse on four out of five key indicators - frequency of consulting a preferred doctor, ability to get a convenient
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was the largest practice in England in 2014, with 62 partners and more than 100,000 patients. Maintaining general practices in isolated communities has become very challenging, and calls on very different skills and behaviour from that required in large practices where there is increasing
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patients, 10.3%, in October 2018, compared to 9.4% in November 2017, did not see the doctor until at least 21 days after they had booked their appointment, and 1.4 million waited for more than 28 days. More than a million people each month failed to turn up for their appointment.
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A new GP contract was announced in June 2018 by the Northern Ireland Department of Health. It included funding for practice-based pharmacists, an extra £1 million for increased indemnity costs, £1.8 million because of population growth, and £1.5 million for premises upgrades.
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which described the existing general practice model as "outdated". He is said to be "considering radical changes to the 70-year-old structure of the NHS that could see many family doctors directly employed by hospitals instead of running their own surgeries."
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specialisation. By 1 October 2018, 47 GP practices in England had a list size of 30,000 or more and the average list size had reached 8,420. In 2019 the average number of registered patients per GP in England has risen since 2018 by 56 to 2,087.
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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.
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practice nurses and administrative staff. Often other health professionals such as allied health practitioners en pharmacists are part of general practice teams to provide an integrated multidisciplinary healthcare team to deliver primary care.
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More than 80% of GPs feared patients may be at risk from bad decisions because GPs are overworked and understaffed in March 2022. In September 2022 1.45 million patients waited at least 28 days before seeing a GP. In November 2022 GPs told
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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
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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.
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collected undated resignation letters in 2017 from GPs who threatened to leave the NHS and charge consultation fees. They demanded increased funding, more recruitment and improved computer systems.
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Commercial providers are rare in the UK but a private GP service was established at Poole Road Medical Centre in Bournemouth in 2017 where patients can pay to skip waiting lists to see a doctor.
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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
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list size in June 2017 was 7,860. There were 1.35 million patients over 85. There has been a great deal of consolidation into larger practices, especially in England.
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to manage the increasingly complex medication regimes of an aging population. In 2017 more than 1,061 practices were employing pharmacists, following the rollout of
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There have been particularly acute problems in general practice in Northern Ireland as it has proved very difficult to recruit doctors in rural practices. The
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epidemic in 2020 general practice shifted very quickly to remote working, something which had been progressing very slowly up to that point. In the
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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
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57 million GP consultations in England in 2015 were for minor conditions and illnesses, 5.2 million of them for blocked noses. According to the
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most days they breach the British Medical Association (BMA) guideline of "not more than 25 contacts per day" to provide safe care. In March 2021
50:(GP) is a doctor who is a consultant in the discipline of general practice. GPs have distinct expertise and experience in providing whole person 894: 1429: 789: 184:
In Ireland there are about 2,500 General Practitioners working in group practices, primary care centres, single practices and health centres.
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care whilst managing the complexity, uncertainty and risk associated with the continuous care they provide. GPs work at the heart of their
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warned that it risked 'undermining the quality and continuity of care and further fragmenting the service provided to the public'.
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Hobbs, F D Richard; Bankhead, Clare; Mukhtar, Toqir; Stevens, Sarah; Perera-Salazar, Rafael; Holt, Tim; Salisbury, Chris (2016).
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Irving, Greg; Neves, Ana Luisa; Dambha-Miller, Hajira; Oishi, Ai; Tagashira, Hiroko; Verho, Anistasiya; Holden, John (2017).
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announced a programme designed to recruit around 2,000 GPs from the EU and possibly New Zealand and Australia. According to
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appointment, rating of doctor communication skills, ease of contacting the practice by telephone and overall experience.
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led to a sudden move to remote working. In March 2020 the proportion of telephone appointments increased by over 600%.
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Greaves, Felix; Laverty, Anthony; Pape, Utz; Ratneswaren, Anenta; Majeed, Azeem; Millett, Christopher (May 2015).
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a 1% deterioration in access to general practice can produce a 10% deterioration in emergency department figures.
1382:"Clinical workload in UK primary care: A retrospective analysis of 100 million consultations in England, 2007–14" 210: 721: 697: 671: 262:
which processes up to 3000 consultations per hour. Video calling is used to "see" patients if that is needed.
408: 1306: 85:, evidence base and clinical activity. Characteristics that define the discipline of general practice are: 1333:"International variations in primary care physician consultation time: A systematic review of 67 countries" 916: 443: 1140: 494: 370: 326: 202: 258:
reported that "99% of all our work is now online" using a digital triage system linked to the patient's
1031:"Performance of new alternative providers of primary care services in England: an observational study" 1667: 451:
shorter than the mean consultation length in a number of other developed countries around the world.
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Kmietowicz, Zosia (7 January 2006). "A century of general practice". British Medical Journal.
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in 2016 promised £2.4 billion (14%) real-terms increase in the budget for general practice.
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General practice is personal, family, and community-orientated comprehensive primary care
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Please help update this article to reflect recent events or newly available information.
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have taken over multiple GP practices in the interests of integration. In March 2022
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did a survey which revealed GPs were dealing with 37 patients per day on average.
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Patient-based medical care provided across age, gender and specialty boundaries
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GPs in England treat up to three times more patients than safety limit demands
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Over 80% of UK GPs think patients are at risk in their surgery, survey finds
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service though they often operated in more deprived populations.
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The pattern of services in the UK was largely established by the
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American Medical Schools and the Practice of Medicine: A History
546: 33: 1430:"More patients waiting longer than a week for GP appointments" 871:. Building Better Healthcare. 27 February 2019. Archived from 369:
managing long-term conditions, or doing home visits. In July
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The general practice model is used in countries such as the
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is personal, family, and community-orientated comprehensive
1379: 1187:. Pharmaceutical Journal. 28 September 2017. Archived from 1163:"Revealed: Next 67 areas recruiting 'clinical pharmacists'" 986:"Sharp rise in GP practices with more than 30,000 patients" 1610:"Funding boost for general practice in Northern Ireland" 1540:"GP services run by private firms 'worse for patients'" 1283:. Commissioning Review. 7 November 2016. Archived from 869:"Half of all GP surgery buildings 'unfit' for purpose" 205:
which established the list system which came from the
244:, almost 90% of salaried GPs were working part-time. 1634: 1326: 1324: 1584:"NI GPs move step closer to leaving health service" 1636: 516: 514: 1321: 1213:. Healthcare Leader. 22 June 2017. Archived from 713: 576:Royal Australian College of General Practitioners 1659: 1307:"GP contacts with patients up 7.5% in two years" 1139:. Healthcare Leader. 1 July 2017. Archived from 623:"The pharmacist in a primary healthcare setting" 511: 333: 405:Yeovil District Hospital NHS Foundation Trust 81:discipline with its own educational content, 1259:"'GP federations' are the future of the NHS" 110:professional, clinical and ethical standards 1022: 964:"Embracing island life as a GP in Shetland" 895:"Nearly 600 GP practices closed since 2010" 401:Northumbria Healthcare NHS Foundation Trust 1063: 745: 720:Beech, Jake; Baird, Beccy (11 June 2020). 719: 620: 1405: 1356: 1054: 922:. British Medical Association. April 2017 751: 638: 627:Journal of Pharmacy Practice and Research 597:"General Practitioners or Family Doctors" 1035:Journal of the Royal Society of Medicine 621:Page, Amy T.; Somers, George T. (2015). 220: 32: 1520:. Health Service Journal. 30 April 2020 792:. Health Service Journal. 27 March 2020 661: 479: 474:COVID-19 pandemic in the United Kingdom 148:, similar services may be described as 116:continuing evolution of the speciality. 1660: 1476:. Southern Daily Echo. 6 February 2017 1239:. Health Service Journal. 4 March 2022 1165:. Chemist & Druggist. 18 July 2017 1117:. Health Service Journal. 17 July 2017 1115:"NHS to recruit 2,000 GPs from abroad" 897:. Health Service Journal. 14 July 2015 551:Royal College of General Practitioners 689:Royal Commission on the NHS Chapter 7 352:In 2004, regulations were changed in 233:Most services are provided under the 1564:. Belfast Telegraph. 19 January 2017 722:"GP funding and contracts explained" 461:GP at Hand, an online service using 413:Southern Health NHS Foundation Trust 283: 488: 13: 1628: 1137:"10 ways a vanguard improved care" 1073:. UK Parliament. 2004. SI 2004/291 430:have become popular among English 360:The GP Forward View, published by 104:coordination and clinical teamwork 14: 1679: 235:General Medical Services Contract 196: 144:. In some countries, such as the 437: 288: 211:National insurance contributions 101:diagnostic and therapeutic skill 1602: 1576: 1554: 1532: 1510: 1488: 1466: 1444: 1422: 1373: 1299: 1273: 1251: 1229: 1203: 1177: 1155: 1129: 1107: 1085: 1000: 978: 956: 934: 909: 887: 861: 836: 820: 804: 782: 760: 380:GPs are increasingly employing 113:leadership, advocacy and equity 1562:"2o GP surgeries face closure" 680: 655: 614: 589: 564: 539: 526:Medical Council of New Zealand 237:, which is regularly revised. 107:continuous quality improvement 41: 1: 1635:William G. Rothstein (1987). 1498:. GP Online. 18 December 2017 1398:10.1016/S0140-6736(16)00620-6 504: 409:Royal Wolverhampton NHS Trust 1542:. GP Online. 3 November 2017 988:. GP Online. 16 October 2018 917:"General practice in the UK" 444:Local Government Association 334:Number and size of practices 187: 7: 1643:. Oxford University Press. 1349:10.1136/bmjopen-2017-017902 495:British Medical Association 327:British Medical Association 279: 203:National Insurance Act 1911 10: 1684: 1261:. Telegraph. 11 March 2010 849:. Kings Fund. 2 March 2011 662:Timmins, Nicholas (1995). 347: 325:, but few were built. The 247:Under the pressure of the 225:Lloyd George envelopes at 179: 1095:. GP Online. 20 June 2017 944:. GP Online. 20 June 2017 297:This section needs to be 260:electronic patient record 1612:. OnMedica. 11 June 2018 1309:. GP Online. 1 June 2017 1047:10.1177/0141076815583303 666:. Fontana. p. 107. 601:Health Service Executive 1432:. Guardian. 6 July 2017 73:General practice is an 1454:. ITV. 7 December 2018 419:supported a report by 230: 38: 1010:. Pulse. 11 July 2019 966:. Pulse. 27 June 2016 432:General practitioners 224: 36: 1392:(10035): 2323–2330. 547:"Definition of a GP" 480:Patient satisfaction 48:general practitioner 1191:on 24 December 2017 770:. Pulse. 8 May 2019 692:. HMSO. July 1979. 572:"Choose to be a GP" 341:Lakeside Healthcare 522:"General practice" 231: 229:Health Centre 2012 207:friendly societies 92:continuity of care 89:person centredness 39: 1650:978-0-19-536471-2 1590:. 25 January 2017 640:10.1002/jppr.1136 442:According to the 354:Labour government 318: 317: 158:community nursing 98:whole person care 95:comprehensiveness 1675: 1668:General practice 1654: 1642: 1622: 1621: 1619: 1617: 1606: 1600: 1599: 1597: 1595: 1580: 1574: 1573: 1571: 1569: 1558: 1552: 1551: 1549: 1547: 1536: 1530: 1529: 1527: 1525: 1514: 1508: 1507: 1505: 1503: 1492: 1486: 1485: 1483: 1481: 1470: 1464: 1463: 1461: 1459: 1448: 1442: 1441: 1439: 1437: 1426: 1420: 1419: 1409: 1377: 1371: 1370: 1360: 1328: 1319: 1318: 1316: 1314: 1303: 1297: 1296: 1294: 1292: 1277: 1271: 1270: 1268: 1266: 1255: 1249: 1248: 1246: 1244: 1233: 1227: 1226: 1224: 1222: 1207: 1201: 1200: 1198: 1196: 1181: 1175: 1174: 1172: 1170: 1159: 1153: 1152: 1150: 1148: 1133: 1127: 1126: 1124: 1122: 1111: 1105: 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Index

primary care
diagnosis
General practice is personal, family, and community-orientated comprehensive primary care
general practitioner
medical
communities
families
physical health
mental health
academic
scientific
research
United Kingdom
Australia
New Zealand
the Netherlands
India
South Africa
United States
family medicine
primary care
community nursing
allied health
pharmacy
optometrist
dentistry
National Insurance Act 1911
friendly societies
National insurance contributions
patient record

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