How primary care is developing

The 1997 NHS Primary Care Act introduced greater flexibility in the delivery of primary health care services for patients. The new law allows GPs, dentists, NHS trusts and NHS staff to develop, with health authorities and health boards, new ways of delivering their primary care services.

From October 1998 pilot schemes began in areas with high levels of illness and where it is often difficult to recruit GPs. There are two types of scheme:

· one which will enable NHS trusts or GP practices to employ GPs on a salary (instead of a self-employed basis), with the aim of giving patients who live in areas of high health risk access to a flexible family doctor service;

· one to create primary health care 'one-stop shops' where GPs, community nurses and other professionals work as a single team in the community offering a range of services from eye tests to counselling.

The new Primary Care Groups - local partnerships between family doctors and community nurses - will be expected to play an increasing role in taking decisions about services for patients.