ABSTRACT

This chapter explains the patient need, demand and use of primary care. It highlights the coexistence of different interests in the process of defining needs and demand for care. Of particular relevance to primary care health services' research is the observation that different concepts of need coexist within National Health Service (NHS) policy-making. The lack of a coherent approach to needs definition within the NHS has evoked some criticism. Within primary care, the lack of clarity about need definition within the NHS more generally is accentuated. The chapter concerns about 'inappropriate demand' have been fuelled by evidence of increasing demand for out-of-hours services. How much such increases are a result of patient demand, or changes in remuneration and practices on the part of primary care professionals, is a moot point. Nonetheless, the use of such services has understandably concentrated attention on how to manage and reduce patient demand.