Shifting the balance from secondary to primary care

Abstract

In Britain, boundaries are already shifting. Some procedures are being transferred from hospital to community settings. For example, triage systems and hospital at home schemes are being established to avoid hospital admissions and facilitate early discharge; attempts are being made to reduce the number of patients referred inappropriately to specialist services by developing and implementing referral guidelines; general practitioners and community nurses are being encouraged to develop new skills and new practice based facilities; shared care schemes are being introduced for chronic disease management, paediatrics, mental health, and maternity care; and some general practitioners and specialists are experimenting …