Personal medical services | • To make primary care more locally responsive | • Allowing participating GPs the option of being salaried | Previously under-served groups |
| • To address problems of GP recruitment and retention | • Allowing nurses and former community trusts to take a lead on providing primary care for the first time | |
| • To enable closer working relationships within the PCT | • Allowing GPs the option of providing extended services | |
| • To introduce greater flexibility in general practice | • Providing primary care services in areas where care has been previously unavailable | |
| • To address inequalities in the provision of health care | • Targeting services to the needs of local vulnerable and marginalised groups | |
Telephone consultations with GPs or nurses | • To reduce unnecessary face-to-face consultations | • GPs and nurses utilise telephone consultations to triage patients, and provide telephone advice and authorise repeat prescriptions where appropriate | Patients requesting same-day appointments |
Nurse practitioner-led care | • To increase access to primary care in under-served areas | • Nurses roles are developed through increased training opportunities so that they may work independently, diagnosing, prescribing, treating and referring patients onwards where appropriate | Patients consulting for minor conditions in busy general practice sites |
| • To reduce GP workload for minor conditions | | |
Walk-in centres | • To provide more easily accessible primary care that is centred around the needs of the local population | • Nurse-led primary care centres established in convenient areas with extended opening hours and walk-in access, providing health care/advice for minor conditions and health promotion | Local communities |
| | • Nurses are supported by computerised clinical decision software and frequently a GP is available on-site | |
NHS Direct | • To provide more easily accessible primary care | • A 24-hour nurse-led telephone service offering healthcare advice and acting as a triage point for referrals to other services | All of England and Wales |
| • To reduce unnecessary demand on other primary care services | • NHS Direct effectively utilises skill mix employing nurses, trained call handlers and GPs | |
| | • Nurses are supported by computerised clinical decision-making software | |
| | • NHS Direct is available online | |
Pharmacist-led initiatives | • To provide more easily accessible primary care for minor conditions | • The role of the community pharmacist is enhanced to include medicine management; pharmacists are able to dispense certain medications without a prescription from a GP (pharmacists are guided by a prescription formulary) | Patients with self-limiting/minor conditions |
| | • To reduce unnecessary demand on other primary care services | • NHS Direct is able to refer directly in some instances to community pharmacists |
| | • Training programmes and skills checks have been established for pharmacists | |