What has gone wrong with the NHS, and in particular with general practice? Why can’t we get an appointment to see our GP? And who is our GP, anyway?
The UK National Health Service is always in crisis, yet it has been shown, time and time again, that the public value it more highly than anything else in British society. Now things seem worse than ever. Why? And in particular, what has gone wrong with general practice?
It may come as a surprise that general practice has in many ways become a victim of its own success. Put simply, the scope of its work has outgrown the resources available for delivering those services. Patients are fed up, and staff are worn out, demoralised and leaving the service. Practice Matters explains how this situation came about?
Between 1974 and 2006 UK general practice underwent an astonishing evolution, moving from the baggage train of the NHS to become its vital, influential spearhead. The book explains how and why these changes came about. It is the first such account written by a GP whose career spanned that time, and who writes in detail of his own experience of those dramatic advances.
Laced with anecdotes that range from the farcically funny to profoundly sad, the book is part personal memoir, part an outline of the service’s history, and part a description of change: of political intrigue, innovations in buildings, staff and technology, and of the pioneering, individual initiatives that led to the development of modern general practice.
The various parts of the book combine to offer a broad picture of just how general practice has become so important and influential within the NHS. But it also goes on, to draw conclusions and offer ideas about how the service could be developed to make the best use of the resources available to it.
Anyone wanting the NHS to prosper needs to know more about it in order to argue for its preservation and development. Practice Matters will help that process. And those outside the NHS, whether in the UK or abroad, that take an interest in the past, present and future of the NHS will also find this unique book of interest.
İçerik tablosu
PREFACE
ACKNOWLEDGEMENTS
INTRODUCTION
THE FIRST AND THE LAST
PART ONE: IN THE BEGINNING
THE DOCTOR’S TALE
THE PATIENT’S TALE
THE PRACTICE’S TALE
TRAINING TO BE A GP
DOES ANYONE KNOW WHAT WE ARE TRYING TO DO?
PART TWO: A BRIEF HISTORY OF NHS GENERAL PRACTICE
THE EARLY DAYS OF THE NHS
BRINGING THE NHS UP TO DATE: 1974–2005
THE FOUR CORNERSTONES
PART THREE: THE THREE LIMBS OF CLINICAL PRACTICE
ACUTE CARE
GETTING THE BALANCE RIGHT
PREVENTIVE CARE
PREVENTIVE MEDICINE IN PRACTICE
CHRONIC DISEASE MANAGEMENT
CHRONIC DISEASE MANAGEMENT IN PRACTICE
PART FOUR: A PRACTICE’S ORGANISATIONAL TRILOGY
A BETTER PLACE TO PRACTICE
FROM A STABLE FOR HORSES TO A CENTRE FOR CARS
BUILDING FOR THE FUTURE
INFORMATION SYSTEMS: THE PAPER YEARS
INFORMATION SYSTEMS: THE EARLY DIGITAL YEARS
AT THE CUTTING EDGE
THE EVOLVING TEAM
MAKING IT HAPPEN: MANAGING A PRACTICE
PART FIVE: POLITICAL FORCES
WORKING WITH THE AUTHORITIES
REFORMING THE REFORMS
PART SIX: IN THE END
PUTTING IT ALL INTO PRACTICE
REFLECTIONS IN TINTED GLASS
LIST OF ABBREVIATIONS
INDEX
ABOUT THE AUTHOR
Yazar hakkında
Until retirement in 2006 Dr Andrew Willis was a British family doctor concerned with the development of the NHS and general practice. He contributed to nine books on various aspects of practice and health service organisation, and advised health authorities, expert groups and government ministers. In 1999 he was invited to give the annual Carl Moore lecture at Mc Master University in Canada.
His professional interests included the development of practice buildings, information systems and personnel, but now in retirement they focus upon grandchildren, photography, gardening and woodwork.
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