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
356:
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
338:
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
450:
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
192:
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
454:
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
484:
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
343:
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
455:
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.
500:
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.
423:
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."
344:
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.
217:
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.
193:
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.
265:
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
58:, striving to provide comprehensive and equitable care for everyone, taking into account their health care needs, stage of life and background. GPs work in, connect with and lead multidisciplinary teams that care for people and their
320:
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
329:
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.
213:. In 1938 43% of the adult population was covered by a panel doctor. When the National Health Service was established in 1948 this extended to the whole population. The practice would be responsible for the
868:
497:
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.
767:
1561:
458:
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.
1280:
687:
240:
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
1210:
521:
1473:
339:
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.
384:
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
872:
826:
493:
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
843:
1236:
1007:
1517:
1136:
963:
251:
epidemic in 2020 general practice shifted very quickly to remote working, something which had been progressing very slowly up to that point. In the
209:
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
446:
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
272:
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.
1284:
404:
54:
care whilst managing the complexity, uncertainty and risk associated with the continuous care they provide. GPs work at the heart of their
1495:
400:
1451:
1214:
1184:
1114:
469:
warned that it risked 'undermining the quality and continuity of care and further fragmenting the service provided to the public'.
810:
1380:
Hobbs, F D Richard; Bankhead, Clare; Mukhtar, Toqir; Stevens, Sarah; Perera-Salazar, Rafael; Holt, Tim; Salisbury, Chris (2016).
473:
1258:
1648:
1331:
Irving, Greg; Neves, Ana Luisa; Dambha-Miller, Hajira; Oishi, Ai; Tagashira, Hiroko; Verho, Anistasiya; Holden, John (2017).
373:
announced a programme designed to recruit around 2,000 GPs from the EU and possibly New Zealand and Australia. According to
412:
1162:
1092:
485:
appointment, rating of doctor communication skills, ease of contacting the practice by telephone and overall experience.
1539:
476:
led to a sudden move to remote working. In March 2020 the proportion of telephone appointments increased by over 600%.
1609:
941:
1029:
Greaves, Felix; Laverty, Anthony; Pape, Utz; Ratneswaren, Anenta; Majeed, Azeem; Millett, Christopher (May 2015).
985:
377:
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.
259:
161:
248:
234:
746:
Kmietowicz, Zosia (7 January 2006). "A century of general practice". British Medical Journal.
1070:
353:
364:
in 2016 promised £2.4 billion (14%) real-terms increase in the budget for general practice.
431:
47:
1583:
1188:
8:
340:
37:
General practice is personal, family, and community-orientated comprehensive primary care
571:
303:
Please help update this article to reflect recent events or newly available information.
1406:
1381:
1357:
1332:
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1030:
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415:
have taken over multiple GP practices in the interests of integration. In March 2022
1644:
1637:
1411:
1362:
693:
667:
644:
157:
1474:"NHS GP practice sets up a private service - by paying up to £145 to jump the queue"
1401:
1393:
1352:
1344:
1071:"The National Health Service (General Medical Services Contracts) Regulations 2004"
1050:
1042:
747:
634:
206:
276:
did a survey which revealed GPs were dealing with 37 patients per day on average.
466:
420:
374:
149:
63:
1348:
768:"NHS England says almost 90% of GPs work part time in response to Pulse survey"
462:
447:
214:
121:
16:
Patient-based medical care provided across age, gender and specialty boundaries
1093:"Jeremy Hunt: The NHS is turning a corner - and I want GPs at the heart of it"
827:
GPs in England treat up to three times more patients than safety limit demands
1661:
1046:
648:
427:
322:
145:
67:
811:
Over 80% of UK GPs think patients are at risk in their surgery, survey finds
596:
1415:
1366:
830:
814:
392:. It was estimated that they had saved 930 GP hours over a 10-month trial.
268:
255:
252:
153:
141:
62:, respecting the context in which they live, aiming to ensure all of their
23:
221:
1237:"Javid backs report calling for GPs to be 'directly employed' by the NHS"
416:
385:
365:
361:
241:
133:
129:
1281:"Millions of 'unnecessary' GP visits are for coughs and colds, says LGA"
790:"Primary care has transformed into a 'dial-in' or 'click first' service"
381:
78:
1496:"Cherry picking fears confirmed as 7,000 new patients join GP at Hand"
639:
622:
396:
389:
173:
169:
125:
55:
27:
165:
82:
59:
51:
1518:"Official data demonstrates rapid rise of remote GP consultations"
1452:"One in 10 patients waiting three weeks to see GP, figures reveal"
1211:"How is primary and secondary care integration impacting trusts?"
357:
service though they often operated in more deprived populations.
226:
201:
The pattern of services in the UK was largely established by the
74:
30:, continues over time and is anticipatory as well as responsive.
1639:
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
156:. The term primary care may include services provided by GPs,
1330:
1185:"Primary care 'Care navigators' to help free up GP schedules"
1028:
942:"Number of GP practices drops by more than 650 in four years"
844:"The evolving role and nature of general practice in England"
137:
1008:"Number of registered patients per GP rises to almost 2,100"
739:
120:
The general practice model is used in countries such as the
22:
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:
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1510:
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1466:
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1422:
1373:
1299:
1273:
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1203:
1177:
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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
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875:on 12 April 2019
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489:Northern Ireland
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20:General practice
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1629:Further reading
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1343:(10): e017902.
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726:The King's Fund
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664:The five giants
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467:Richard Vautrey
440:
421:Policy Exchange
375:NHS Improvement
350:
336:
314:
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305:
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293:
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199:
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182:
150:family medicine
134:the Netherlands
70:needs are met.
64:physical health
44:
17:
12:
11:
5:
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654:
633:(3): 257–258.
613:
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509:
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463:Babylon Health
439:
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428:GP Federations
349:
346:
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332:
323:health centres
316:
315:
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215:patient record
198:
197:United Kingdom
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122:United Kingdom
118:
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26:that includes
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2:
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