1. Practitioners with Special Interests GPSIs

2. The NHS Plan (July 2000) envisaged that by 2004 ; ‘ upto 1000 specialist GPs will be taking referrals from fellow GPs for conditions in specialities such as ophthalmology, orthopaedics, dermatology and ear nose and throat surgery,. They will also be able to undertake diagnostic procedures such as endoscopy’ (ch 12,para.7

3. Improvement, Expansion and Reform : Priorities and Planning Framework 1003-2006 (Oct 2002) states that by 2006 there will be an increase in: ‘ activity taking place in primary and community settings to contribute to the national assumption that at least one million more outpatient appointments ( around 10%) take place in the community rather than the hospital ‘

4. Two broad categories of activities that may be undertaken by GPwSIs : Delivering a clinical service Undertaking of procedures

5. The Big Idea Allowing GPs to deliver a clinical service beyond the normal scope of general practice,undertake advanced procedures, or develop services Increase the capacity of primary care to undertake outpatient appointments Reduce patient waiting times Provide a more convenient service Free up consultant time in secondary care

6. IMPLICATIONS Expansion of the physical capacity in primary care Premises Premises One-stop shops One-stop shops Diagnostic and treatment centres Diagnostic and treatment centres

7. Which Specialties? Care for older people Child protection Coronary heart disease DermatologyDiabetes Drug misuse EchocardiographyENTEpilepsyHeadaches Mental health Musculoskeletal conditions Palliative care Respiratory medicine Sexual health

8. Guidelines No particular training courses DOH and RCGP framework Process of accreditation by employer Determines the core competencies to deliver the particular service, and the evidence required to demonstrate that a GP has met these competencies, and the criteria for their maintenance. Determines the core competencies to deliver the particular service, and the evidence required to demonstrate that a GP has met these competencies, and the criteria for their maintenance.

9. Further Information www.natpact.nhs.uk/specialinterestswww.doh.gov.uk/pricare