Community oriented primary care

摘要

Over 9000 general practitioners, covering more than a third of the population of England and Wales, have opted to become fundholders. They have taken the responsibility for managing budgets for staff, premises, and prescribing and for some hospital and community health services. The remaining 21 000 non-fundholding general practitioners are also taking greater responsibility for commissioning health services, either as part of commissioning groups or through locality purchasing. To become effective commissioners of health services, fundholding general practitioners will need skills in disciplines that are usually seen as the remit of public health specialists and health service planners, such as epidemiology, needs assessment, and health service planning. In short, fundholders are expected to take on many of the roles of district health authorities and family health services authorities but at a practice level.