ABSTRACT

This chapter discusses the three main themes discussed so far – having common values and philosophies, being aware of the management needs of an organisation and working across boundaries – the link with accountability, and the authors' fourth major underlying cause of difficulty for general practice. In common with all doctors, General Practice's (GPs) have always been accountable – it is the extent and nature of that accountability that is changing. Accountability in professions was largely limited to dealing with unethical behavior in any members that might undermine the reputation and standing of the club. Trust and professional conscience largely regulated clinical practice, although breaches of terms of service could trigger action. Concern to take account of the concepts of quality and accountability in the eyes of the public was not common. The example present in this chapter illustrates something of this, taken as it is from one of the earliest practice visits carried out.