ABSTRACT
A policy of developing General Practitioner with a Special Interest (GPwSI) clinics was announced in the National Health Service (NHS) Plan, with the aim of managing uncomplicated patients in primary care, thereby freeing up the consultants to focus on looking after patients with serious conditions. In 2002, the Department of Health and the Royal College of General Practitioners described the role of a GPwSI as delivering a clinical service beyond the scope of general practice, undertaking advanced procedures or developing services. Most GPs have made a significant difference to the management of Chronic Obstructive Pulmonary Disease patients since the introduction of this in primary care as part of the Quality and Outcomes Framework. The introduction of Payment By Results, which encourages all NHS providers to collect more detailed information about the true cost of providing different types of services in different settings, should make the cost of GPwSI services more transparent.
