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International Primary Care Association

Clinical Focus Volume 1 N3


The latest Government’s primary care white paper ‘Our health, our care, our say: a new direction for community services’ shows further support for the development of Practitioners with special interests (PwSIs), practice-based commissioning and community hospitals. Yet issues of training, accreditation, continuing professional development and remuneration remain unclear. At an individual level, these areas are highly relevant and topical. Through these constantly changing NHS times, we hope to bring some clarity and guidance on these more practical matters, not only through this journal, but more so through the open forum on our website The Association of Practitioners with Special Interests (APWSI) is expanding steadily, and our 3rd annual conference "Enhancing the delivery of healthcare" is a further opportunity to tackle these hot topics in a more personal and interactive arena.

In this issue, Drs Peter Stott and Anne Hollings, Medical Directors of EDICS (Epsom Downs Integrated Care Service), one of the largest practice based commissioning groups in the UK, give us a valuable insight into the broad role that a GPwSI can provide. For those medical professionals out there who still think that GPwSIs are ‘glorified’ and better paid clinical assistants, then we hope that this article will persuade them otherwise. It is well recognised that it takes years of training to become a secondary care specialist. GPs working at an intermediate level of healthcare have more of a role to play than just increasing service capacity. That is not to say that with appropriate case selection and support, a significant case load cannot be dealt with effectively. However, GPs have always been best placed to understand their patients’ needs, and now the opportunities to manage and run more patient-centred services, closer to home, are becoming more readily available.

Increasing numbers of hospital consultants are forming professional chambers and offering their services to commissioning groups. In some areas, it has been the GPs who have set the ‘Chambers’ up, working with a whole range of independent practitioners, albeit mostly consultants.1 This is likely to expand further as Foundation Trusts ‘go live’ nationally and GPs compete with other private providers, as the market to commission services opens up even more. Watch this space!

1. ‘The GPs in chambers’. MedEconomics. December 2005.



Dr Alexander Watson
Professor Ram Dhillon

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