ABSTRACT
The services available in primary care have increased dramatically over recent years. General practices' (GPs') lists have had to fall as the doctors come under growing pressure from their ever more demanding patients who consult far more readily and more frequently than before. The number of practice nurses employed has risen as they have been required, in addition to their normal treatment room duties, to take on the care of patients with chronic conditions such as asthma and diabetes, as well as organizing immunizations and cytology testing to ensure targets are met. It is not uncommon for physiotherapy, acupuncture, counselling, chiropody, osteopathy and homeopathy to be available under the same roof in general practice. The number of ancillary staff required to run these busy surgeries has also increased with most practices now employing a practice manager, and many having another manager whose sole responsibility is to control the fundholding budget or the financial side of the business.
