ABSTRACT
This chapter considers the different forms of relationship between hospitals and other providers. It looks briefly at the implications for hospital organisation. With the exception of some accident and emergency care, hospitals in the UK system form part of a 'mixed mode' since most hospital care episodes begin with the general practitioners (GP) surgery and many end with it or with a community nursing service. Within the UK health care system the hospital depends for the vast majority of its work on other care providers. The gate-keeping role of general practice is a system of demand management for the hospital over which it has no control within the current structure of health services. Hospital accident and emergency departments carry out a large amount of work which could easily be carried out by a GP or a practice nurse: estimates vary as to its extent, but figures of 30-40 per cent are often quoted.
