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International Primary Care Association

Clinical Focus Volume 4 N2

IPCA Admin

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The new government white paper clearly identifies community services as the cornerstone of the NHS and this should provide a great opportunity for GPwSIs. However progress in setting national standards for training, accreditation, service delivery and continuing professional development has been slow. This article aims to highlight some of the key areas that must be addressed and provides insight into possible solutions. There are innovative approaches to these problems throughout the country but now more than ever clear National guidance is needed so that opportunities to fully utilise the potential of primary care physicians are not lost.


General Practitioner with a Special Interest (GPwSI) services have increased significantly since the late 1990s and have added a valuable dimension to service delivery providing effective services in tune with the vision set out in the NHS Plan.


Robust accreditation is essential for the successful commissioning of GPwSI care. In this article accreditation is defined, the framework that PCOs need to consider when developing their accreditation process is outlined and the application for accreditation discussed.


Post Traumatic Stress disorder (PTSD) is a condition of increasing prevalence and significant morbidity.

In the wake of recent terrorist and natural disasters around the world, practitioners will be faced with increasing numbers of patients presenting with psychological and physical symptoms of PTSD. Patients will often be reluctant to disclose information. Therefore practitioners should try to elicit symptoms of PTSD in suspected patients by direct questioning. First line treatment for PTSD is based around a Cognitive Behavioural Therapy approach, with pharmacotherapy being used as a second line or adjunctive therapy. With better identification and assessment of possible sufferers treatments can be targeted more effectively, reducing the psychological, physical and economic burdens of this condition.


The syndrome AIDS was first recognized in 1981 and the retrovirus was subsequently isolated in 1983. By 1985 serological tests to detect the evidence of infection were developed and by 1996 highly active antiretroviral therapy (HAART) became widespread use in clinical practice which has markedly changed the natural history of the infection. The clinical manifestations of HIV progressing to AIDS are diverse which general practitioners should be alerted to and their management should involve the primary care team.

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