Primary Care and Mental Health

GPs, practice nurses, dentists, pharmacists and opticians form the primary care level of the NHS and, as such, are the ‘front line’ of the health service. On the whole, patients cannot consult a doctor in secondary care such as a hospital consultant or member of a community mental health team unless they are referred by a GP. This filtering process has led to GPs being described as the ‘gatekeepers’ of the NHS. The core group of staff working in a practice is known as the ‘primary health care team’. The actual composition of any primary health care team differs between practices but the Royal College of General Practitioners (RCGP, 2002) has identified a core team as consisting of: GPs, practice nurses, district nurses, health visitors, practice managers and administrative staff. In some surgeries, midwives, physiotherapists, counsellors and community psychiatric nurses are also members of the team.