The reorganization of general practice and the NHS mean that GPs now face many new and distinctive ethical dilemmas in their practice. With pressure on resources and an increasing concern to evaluate the outcomes of health care, GPs have additional responsibilities that could conflict with the primary objective of caring for the individual patient.
General Practice and Ethics explores the ethical issues that are encountered by GPs in their everyday practice, addressing two central themes; the uncertainty of outcomes and effectiveness in general practice and the changing pattern of general practitioners' responsibilities. Among the topics examined are:
* the ethical implications of the use of evidence-based medicine in general practice
* consent, autonomy and confidentiality in general practice
* the history of patient-centredness
* research ethics in general practice
General Practice and Ethics presents a topical and comprehensive analysis of the kinds of ethical dilemmas faced by GPs on a daily basis which will be useful to practitioners and students alike.

Primary healthcare premises are increasingly becoming more sophisticated, offering health promotion, minor surgery and specialist services. The acquisition of new premises, expansion or investment in traditional surgeries can be the greatest financial commitment and also one of the most daunting. This book is specifically written to enable development with minimal disruption to the daily medical routine. The book contains viewpoints of specialists with many years' experience gained from working in their individual fields. It is essential reading for GPs, trainees, practice managers and professional advisers to general practice. Specialist architects, solicitors, financial advisors, accountants and health authority managers will also achieve a better understanding of this complex subject.

Private medical practice is an attractive option for career development. In the United Kingdom it forms a significant industry, yet little has been done to assist medical consultants in managing their businesses. This book gives clear advice to all medical practitioners on both business management and performance. It outlines ways to improve financial performance and economic efficiency in a constantly changing market. It reveals some of the 'secrets' of the successful business professional, and relates business management theories and techniques to real day-to-day problems. Written by a practising accountant and business advisor, this book provides help with finance, banking, taxation, staffing, marketing, medical insurance companies, and business planning, and considers future developments. It is essential for all those contemplating or currently working in private medical practice, and valuable to business, legal and financial professionals servicing this field.

Rewritten with the new primary care environment in mind, this greatly expanded and updated edition of Child Mental Health in Primary Care extends the structured approach of the first edition to adoelscent mental health. As in the first edition, Primary Child and Adolescent Mental Health covers each problem in a uniform way, offering definitions, assessment outlines, detailed management options and indications for referral. Numerous case examples further illuminate aspects of many conditions. Comprehensive and practical, the forty-eight chapters of Primary Child and Adolescent Mental Health cover the full range of difficulties and disabilities affecting the mental health of children and young people. The book is divided into three volumes, and can either be read from cover to cover or used as a resource to be consulted for guidance on specific problems. This book is vital for all healthcare professionals including general practitioners, health visitors and other staff working in primary care to assess, manage and refer children and adolescents with mental health problems. School medical officers, social workers and educational psychologists, many of whom are in the front line of mental health provision for children and young people, will also find it extremely useful. Reviews of the first edition: 'This very comprehensive and detailed book provides the tools for primary care health professionals not only to assess a child's needs but in many cases also to implement an initial package of care.' JUST FOR NURSES 'I have no reservation in recommending the book to all people working with children and families in any capacity. An important training text for a variety of professions. A very effective text to be used in daily practice for quick reference.' CHILD AND ADOLESCENT MENTAL HEALTH 'This book is well produced and clearly written. A useful book for anyone interested or involved with children.' FAMILY PRACTICE 'I looked through the book again and again but could not find anything missing.' NURSING TIMES

An integrated, collaborative model for more comprehensive patient care Creating Effective Mental and Primary Health Care Teams provides the practical information, skills, and clinical approaches needed to implement an integrated collaborative care program and support the members of the care team as they learn this new, evidence-based, legislatively mandated care delivery system. Unique in presenting information specifically designed to be used in an integrated, collaborative care workflow, this book provides specific guidance for each member of the team. Care managers, consulting psychiatrists, primary care providers, and administrators alike can finally get on the same page in regard to patient care by referring to the same resource and employing a common framework. Written by recognized experts with broad research, clinical, implementation, and training experience, this book provides a complete solution to the problem of fragmented care. Escalating costs and federal legislation expanding access to healthcare are forcing the industry to transition to a new model of health care delivery. This book provides guidance on navigating the changes as a team to provide the best possible patient care. * Integrate physical and behavioral care * Use evidence-based treatments for both * Exploit leading-edge technology for patient management * Support each member of the collaborative care team Strong evidence has demonstrated the efficacy of a collaborative care approach for delivering mental health care to patients in a primary care setting. The field is rapidly growing, but few resources are available and working models are limited. This book provides a roadmap for transitioning from traditional methods of health care to the new integrated model. Providers ready to move to the next level of care will find Creating Effective Mental and Primary Health Care Teams an invaluable resource.

This book is vital for health service managers and clinicians, in both purchaser and provider organizations, in community and hospital settings. It helps the reader understand the principles and purposes of casemix and provides practical examples of using casemix groupings to manage services better. Its lessons are not just for acute services, but provide a way of understanding the complete spectrum of services required for a wide range of conditions, from individuals at risk to those with irreversible and progressive disease. The book explains why casemix groups are useful and the reasons for grouping and analysing patient records. It focuses on the difference between groupings of patients with conditions, and groupings of intervention episodes. Using both enables better identification of the services required to meet the needs of the population, and better communication between purchasers and providers. It has potential for managing the whole healthcare system from a population based perspective.

Though medically minor and very common, herpes simplex is a condition which is capable of causing considerable distress, for psychological and social as much as physical reasons. Herpes Simplex contrasts the image of the condition presented in the media with the medical and epidemiological evidence, and discusses ways in which the distress associated with the condition can be alleviated.
The first part of the book examines the impact of diagnosis and then explains the roles of accurate information and empathic support, medical treatment and support groups in learning to live with recurrent symptoms. Other chapters use the experiences of people with the condition in different parts of their bodies to illustrate how the meaning of herpes simplex and response to the symptoms alters in association with life changes. The final chapters review psychosocial research, discuss the importance of the Herpes Viruses Association in acquiring a store of knowledge about people's experiences, and highlight the significance of herpes simplex as a public health problem.
Herpes Simplex demonstrates the importance of a biopsychosocial approach. It will be invaluable to doctors, nurses and other health professionals, as well as to people troubled by the condition.

eBook available with sample pages: 0203137132

Presents information and advice on the extended role of the practice manager for both those with experience and increasing responsibility, and for those new to the primary care team. The book: identifies the various members of the primary health-care team; describes their individual roles; explores the management skills needed to manage the team and the practice; provides examples of real problems experienced in general practice; and examines communication in all its forms.

Managed care organizations are paving the way to the future of health care delivery in the United States and countries around the world. As managed care systems evolve, a major concern is quality. Managed Care Quality: A Practical Guide is a collection of applications and experiences gathered from practicing health professionals in the field of managed care. This first "how to" guide was written to help managed care organizations meet the common objective of ensuring the best quality of services and care. Managed Care Quality: A Practical Guide presents successive steps in implementing quality in health care organizations. It introduces the methods, skills, and practices involved in quality health care programs and offers solutions to problems typically encountered in managed care.

Other titles in the National Primary Care Research and Development Centre series: NPCRDC: What is the Future for a Primary Care-led NHS? NPCRDC: Primary Care: Understanding Health Need and Demand NPCRDC: Better Building for Better Services NPCRDC: Primary Care and Social Services: developing new partnerships for older people NPCRDC: Primary Health Care and the Private Sector

This second edition reviews recent reforms and the likely impact of future developments in management and competition in the NHS. In particular, it reflects the growing importance of primary care and the continuing debates about health care rationing. It concentrates on the realities and how they can be interpreted to help strategists, managers, clinicians, students and those supplying the NHS understand the mechanism of efficient health care delivery.

Examines how evidence-based medicine can be applied in general practice, and how its benefits can be realized in the form of effective treatments. It argues for rational rationing, using clinical effectiveness to exclude ineffective measures.

This text is based on the practical experience of pilot schemes which have identified a variety of opportunities and innovative ideas which others can adopt and develop. This book is a reference for principals and managers of fundholding practices, those thinking about becoming fundholders, and for the managers of provider units seeking to expand their services, including the commissioning authorities.

The well-loved Oxford Handbook of General Practice is a lifeline for busy GPs, medical students, and healthcare professionals. With hands-on advice from experienced practitioners, this essential handbook covers the entire breadth and depth of general practice in small sections that can be located, read, and digested in seconds. Now in its fifth edition, the Handbook has been fully revised to reflect the major new developments shaping general practice today. Fully updated with the latest guidelines and protocols, this edition offers even more full colour diagrams and tables, and colour-coded chapters on general practice (green), clinical topics (purple), and emergencies (red). Covering the whole of general practice from practice management to hands-on advice dealing with acute medical emergencies, this comprehensive, rapid-reference text will ensure that everything you need to know is only a fingertip away.

'Fundamental changes in the Health Service demand a radical shift in approaches to patient core. The NHS is becoming increasingly led by the primary care sector. This has a greater meaning than simply more involvement of GPs in secondary care purchasing. It means that we start from where the patient is, in their own home and community. We provide care for them there and only move them into secondary services if and when it is appropriate to do so. 'Extending Primary Care shows that it is possible to experiment beyond traditional boundaries in these areas. It will provide encouragement to people who work in some of these difficult settings by showing what can be done... This book could not be more timely as a resource to many managers who will need to extend their own understanding of primary care - in the fullest sense of the whole team of people in primary care and the associated community health services.' From the Foreword by Barbara Stocking

Management controls on prescribing have greater impact on a GP's freedom of choice than on any other matter requiring clinical judgement. However, in order to deliver the most effective patient care, the GP needs a much broader base of knowledge including, for example, an understanding of basic pharmacological principles and the process of conducting clinical trials. This book deals systematically with the practical aspects of prescribing throughout primary care. It provides the busy GP with readily-accessible information so that the benefit to patients and the pratice can be maximized.

This overview of the NHS Research and Development Programme is written by people who are at the leading edge of its implementation. It integrates the issues of research management and funding with the importance of focusing research on the needs of the customer (the NHS) and the challenges of implementing the findings of research into clinical practice. The experience of the authors extends from developing local research networks to managing a national research programme, reflecting the scope of the NHS strategy and the potential of this book.

This work adopts a modern approach to quality assurance and quality improvement in general practice. It provides an introduction to the subject, enabling readers to see how best to proceed in their own practices. It revises and updates previous books by Donald and Sally Irvine on clinical audit by placing audit within the wider quality context. It is designed to provide an easily accessible approach to the basic tenets as well as speculating on the future developments in this area, and should be of interest to all members of the practice team. The themes of the book are illustrated by reference to the five major case studies provided, which describe in some detail the various ways of starting, implementing and maintaining quality assurance in general practice today. Practical examples of Total Quality Management, the use of British Standard 5750, Kings Fund organizational audit, Investors in People, and Fellowship of the Royal College of General Practitioners by assessment, are also provided. These studies are written by the practitioners, medical and non-medical, who have themselves been through the experience of turning theory into practice.

With the advent of the new health authorities, multifunds and consortia, it is likely that the GP's professional leadership of primary care will rapidly become only one of a number of provider options. This book defines some of the future options for the organization of primary care. The evolving possible roles of GPs and practices in these changing circumstances are examined closely. As the new health authorities come into full legislative force, how will they deploy the combined financial allocations for primary and secondary care to support their new capacity to enter into local contracts? Which health care providers will emerge in this market place in response to this shift in commissioning power? These are critical questions for general practice. With contributions from a variety of sources that reflect the varied origins of organizational initiatives, this is a book for planners, providers and purchasers of extended primary care.

All GPs undertake the non-NHS work, some of which can add substantially to practice income. This book describes a wide range of fee-paying work which GPs are uniquely qualified to undertake; it shows how opportunities for this work arise and how to become involved in it. For many, the financial benefits are greatly enhanced by the professional satisfaction such work brings.

The management function is practice-based primary care and who performs it varies by practice. While the number of practice managers increase and their role continues to unfold in response to NHS changes, the development of practice management as a profession is contained if not constrained by GPs, as both employers and as the dominant profession within primary care. This stimulating review of the responsibilities, opportunities and future prospects of management in primary care, based on workshops with GPs and practice managers, identifies their respective management development needs and the ways in which these might be met.

The quality of health care in the US depends on the patient's ability to pay and his or her insurance cover, at an annual cost of $3600 per head of population. In the UK, the quality of care costs less at an annual cost of $1000 per head of population, although care is sometimes delayed through a lack of resources. This book compares the two systems from the viewpoint of primary care, identifying some models of excellence from which both can benefit. It draws on the experience of the NHS reforms in the UK and the political imperative to control costs and improve the service in the US.

The NHS pension scheme is the largest in Europe. This guide explains how it works and how to maximize its benefits and avoid its pitfalls. The book covers: recent changes to the scheme including new provisions for early retirement; personal pensions, financial planning and investment options; advice on preparing for retirement and working after retirement; state benefits; and health and leisure in retirement. It is written for all NHS staff and should be of particular value to GPs and salaried doctors.

General practice is the cornerstone of primary care in the UK. However, this traditional model has been challenged by new visions of its role, particularly a responsibility for improving health as well as for the care of illness, and a responsibility for populations as well as for individuals. This book focuses on the development of general practice as a framework within which community nurses and other professionals can build their contibution to the future of primary care. In so doing it shows how the care of general practice can be maintained and strengthened. This work is intended for all primary care staff, including doctors, nurses and managers, and for anyone interested in the future of primary care in the changing NHS.

For GPs and practice managers the challenge of the NHS reforms is to understand the business context in which general practice operates. Of the many skills learned from commerce and industry needed for the development of an effective strategy, business planning has been demonstrated to bring important benefits to the practice. However, for many the concept is necessary but unfamiliar. This book sets out to demystify the subject, explains the benefits and, by way of numerous examples, shows how they can be applied to the single-handed GP and group practices, whether or not they are fundholders. It suggests that good clinical care is not possible without the necessary planning and management skills to run a business.