National Health Service (NHS) care is provided in two main ways: primary care (GPs and community services) and secondary care (hospitals and specialists).
Primary care is the day-to-day healthcare available in every local area and the first place people go when they need health advice or treatment. It’s the first stop for symptoms that are new or for concerns about physical or mental health.
Primary care includes:
• GPs (general practitioners) – the family or local doctor
• chemists (pharmacies)
• community and practice nurses
• community midwives and health visitors
• family planning or sexual health clinics
• out of hours GP services
• dentists
• opticians
• hearing care providers
What do primary care health professionals do?
Primary care professionals – such as GPs, practice nurses or pharmacists – help take care of the basics of care, focusing on preventing illness, making diagnoses (working out what the problem is), and treating conditions that don’t need hospital care. They also look after pregnant women (antenatal care). As they’re usually the first professionals people go to see when they’re unwell or hurt, they’re considered ‘primary’.
A GP explains what primary and secondary care is.
A GP explains what primary and secondary care is.
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Before we begin can you tell us a bit about what’s the difference between primary care and secondary care and where GP’s fall under this?
Okay. So primary care is basically the people you go to first, so that’s GPs, pharmacists, nurses, also actually includes opticians and dentists, they all come under ‘primary care’. ‘Secondary care’ is care offered by specialists usually up in hospitals and usually you’d be referred to secondary care from someone in primary care.
Okay, so I’m guessing a patient would have to go through primary care first before they can be seen in secondary care?
That’s usually the case, yes. So your GP, if you needed specialist treatment or some service that’s not available in primary care, would refer you to secondary care.
And where does A&E land in these categories?
Yes A&E is kind of in the border really because it’s at the hospital but it does count as a hospital service so, it counts as secondary care.
What does primary care involve?
The aim of primary care is to provide an easy, accessible route to care, whatever the patient’s concern – whether it’s a common minor illness, a long term condition, or to prevent future ill-health through advice, immunisation (injections) and screening programmes (such as cervical screening). Family planning and sexual health services are also part of primary care, and don’t need a GP referral.
In the NHS, the main source of primary health care is general practice – going to see the GP (family or local doctor). GPs deal with a broad range of physical, mental and emotional problems rather than specialising in a particular disease. As well as finding out what’s causing a person’s symptoms, GPs also act on behalf of the patient as an advocate (support), making sure that people who are living with health problems get all the care they need. Depending on the health problem, patients may be referred (passed on) by the GP to hospital or to a specialist.
What to do when local surgery GPs are unavailable
GPs provide ‘out of hours’ care for problems that can’t wait. They are available in the evenings and weekends when someone’s usual surgery is closed.
A GP explains what out of hours care is and what it covers.
A GP explains what out of hours care is and what it covers.
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What is out of hours care and what does this cover?
So out of hours care is GP care, so it’s in the community but when your GP surgery is closed. So most GPs cover from 8:00 in the morning till 6:30 in the evening and some do clinics in the evenings and the weekends as well. But outside those times, other GPs will be offering the same sort of service but to a bigger range of patients.
So are these, is this out of hours service somewhere that patients go to or is it over the phone, cos I know there’s some phone services as well?
Yes, usually what will happen is that you will ring up, you may get some advice over the phone, you may be invited to come to the out of hours centre to be seen by a doctor. Or sometimes the doctor may come to you if that’s necessary.
NHS ‘walk-in centres’ are usually managed by a nurse and are available to everyone. An appointment isn’t needed. Most centres are open every day and outside office hours. Walk-in centres can be used when someone can’t see their GP because the surgery is closed or they can’t get an appointment when they need it. Anyone can also use a walk-in centre if they haven’t registered with a GP. Walk-in centres can be used when the health problem isn’t an emergency.
A GP explains what a walk-in centre is and the kind of problems dealt with there.
A GP explains what a walk-in centre is and the kind of problems dealt with there.
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What is a walk-in centre and what kind of problems are dealt with there?
Yes. Walk-in centres are mostly in big cities and they’re for dealing with urgent problems, usually minor illnesses, things like minor infections or minor cuts and sprains, things like hay fever. They’re run by nurses. You can walk in you don’t have to have an appointment.
Okay.
So they’re very useful for urgent care for small things, but they don’t have your records there and usually there isn’t a doctor there. It’s just a nurse lead service.
And so I’m guessing it’s similar to A&E, well within GP practices.
It’s a little bit like a minor A&E absolutely, but it’s not somewhere you’d go if you had a broken bone.
So if someone went into a walk-in centre and they actually needed medication or something, can someone prescribe them with medication or?
There’d be some limited things that they can prescribe. So they might be able to give them things like antibiotics for a bladder infection or cream for athletes foot or something like that. But they wouldn’t be able to give more serious or long-term medication.
If that was the case and they couldn’t be provided with medication, what happens after a walk-in centre appointment?
So two possibilities: one, if it’s urgent, that patient would be likely to be sent onto A&E.
Okay.
Or if it’s not something that has to be dealt with absolutely immediately, then the patient would be asked to go and see their own GP back at home.
People who have an urgent, serious problem (like a broken arm) can go straight to a hospital Accident and Emergency (A&E) department. If anyone’s in any doubt about where they should go, they can call the NHS 111 service.
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