1. Chapter 34 PRIMARY CARE Sian Maslin-Prothero, Sue Ashby and Sarah Taylor

2. Introduction This presentation provides you with some questions regarding primary care and interprofessional working. You should work through these in your learning groups, following the links for further research, before feeding back your findings.

3. Q. Examine your local community and then list the professionals who work in your local primary healthcare team. Who are they? Q. Now identify the members of the wider community team – who are they? Partnership Working

4. Health policy goes beyond the traditional reach of the NHS to include the wider social, environmental and economic determinants of health. Primary healthcare staff are required to form partnerships/alliances with local authorities, social services, housing, education, welfare, and other statutory and voluntary agencies in order to provide appropriate and relevant care. Service users and the general public are encouraged to take an active role in describing and identifying the health and care needs of their community.

5. Q. Determine what the caseload is for your community nurses or another professional group in your GP practice Q. Do they have a designated geographical area, or an allocation by GP? Q. What is the population size and type of area covered? Care in the Community

6. Community nurses might work in or manage a team (as happens in district nursing) or have sole management of a specific area. Unlike a bed-based service there is no fixed caseload size. The number of clients varies, depending on many factors such as the type, frequency, time and location of visits. A professional in this role needs to continually assess the workload and resources available. If they are conscious of insufficient resources to manage the load safely, they will be required to present risk assessments, and look to negotiate further resources or redirection of care.

7. It is important to be proactive in managing people’s care. This ensures timely transfer to areas of least dependency, or self-care appropriate to the individual, and that skills are directed to the most appropriate professional or area of care In addition to management within the team, the caseload holder will work in an interdisciplinary way across organisations and agencies whenever a client require multidisciplinary expertise. The coordination of this in the community can become complex, and communication is key to ensure everyone concerned is aware of the situation, and safety is maintained for both clients and staff.

8. Primary Care Visit the website below to read the document‘Making a Difference in Primary Care: the challenge for nurses, midwives and health visitors’’. This provides case studies illustrating some developments made in primary care. http://www.dh.gov.uk/en/Publicationsandstatistics/Pu blications/PublicationsPolicyAndGuidance/DH_40 06620

9. Living in a Community Visit this website to access media files available via the Department of Health: http://www.dh.gov.uk/en/Publicationsandstatistics/Pu blications/PublicationsPolicyAndGuidance/DH_09 1445 The site sets out a brief overview of the priorities for the NHS for the coming year. There are further links that provide more detail on the priorities, how they are measured, and how the new arrangements for managing the system will work.

10. Factors Impacting on Health Q. Read through your local authority’s latest census information and determine a demographic profile of the population of your local area. Q. What issues might impact on an individual’s health?

11. The Office for National Statistics (ONS) plans and undertakes the census: http://www.ons.gov.uk/census/get-data/index.html Your local authority web pages should link you to latest local census information and possibly hold additional information and links to identify local issues. http://www.statistics.gov.uk/Census2001/population_ data.asp

12. Conclusion Current health and social policy is bringing care closer to home, with enhanced care provision being provided in the community setting. Using a whole systems approach the roles and responsibilities of the different professions in health and social care can be used to delivery care and services. Voluntary and charitable agencies are essential members of the interdisciplinary and interprofessional team.