Primary care

The vast majority of people are seen by primary care services in the community. They remain the first point of contact most people have with the NHS: between them they cater for about 90 per cent of patient contact with the health service, at half the cost of hospital care. The Government's long-standing policy is to build up and extend these services to relieve the more costly secondary care services of hospital and specialist services.

Primary care is provided by family doctors, dentists, opticians and pharmacists, who work within the NHS as independent practitioners. Other professionals involved in primary care include district nurses, health visitors, midwives, speech therapists, physiotherapists, chiropodists, dieticians and counsellors.

GPs or family doctors are present in every community and they remain the backbone of the health service. They provide essential primary care and act as gatekeepers to other services, referring patients on when necessary. Every year there are some 250 million GP consultations and some six million people visit a pharmacy every day.

Visits to doctors or dentists may be for treatment or for preventative advice. Preventing ill-health is an important part of a GP's work, and most GPs run programmes to prevent heart disease and stroke, to manage chronic diseases such as asthma and diabetes and to improve childhood immunisation rates.

About 80 per cent of GPs work in partnerships or group practices - often as members of primary health care teams. Primary health care teams also include health visitors, district nurses and midwives who are salaried NHS staff, and sometimes social workers and other professionals employed by the health authorities. GPs often work in health centres which offer people a range of health services in one place.

Other key primary care professionals include:

midwives who care for women throughout pregnancy, birth and for 28 days after the baby is born. Some are based in hospital and some go out into the community.

health visitors who promote health for families and are responsible for preventative action. They aim to identify the health needs of the local population and work closely with other NHS colleagues.

district nurses who care for people in their homes or elsewhere outside the hospital setting. Like health visitors, they offer advice in health promotion and education.