A systemic outreach clinic in primary care: which tier is that?

The family clinic at the Highgate Group Practice was established some fifteen years ago and has been described else where (Graham, Senior, Lazarus, Mayer, & Asen, 1992; Senior, 1994). In its current form, the clinic has no formal link with the Tavistock Clinic, but one of the authors (RS), who now works at the Tavistock, was a member of the original team and continues to provide infrequent consultation and supervision to the team. This chapter locates the clinic within the wider culture of general practice and mental health services. We bring the story of the clinic up to date and describe, with illustrations, the more recent work of the team as it has extended into the local community.