The Exceptional Potential of Each General Practice

The Exceptional Potential of Each General Practice

Dr Niall Maguire

Navan

Bedford Medical Centre , Navan

The Exceptional Potential of Each General Practice

•Rural vs Urban

•Core vs Enhanced Practice

•The Primary Care Surgical Association

•Barriers to Enhanced Practice

The Exceptional Potential of Each General Practice

•Rural vs Urban

•Core vs Enhanced Practice

•The Primary Care Surgical Association

•Barriers to Enhanced Practice

The Health Park, Waterford City

European level population density- Stable Night Lights International Institute for Applied Systems Analysis (IIASA)

Census 2011 Population density AIRO NUI Maynooth

Navan Urban (3,168)(1789/km2)

Navan Rural (26,657)(453/km2)

Castletown Kilpatrick (1,017)(29.5/km2)

Census 2011

Cities and suburbs

Towns with population greater than 10000

Towns with population 1500-9999

Towns with population less than 1500

General Practice by Fionn McCann

The Exceptional Potential of Each Consultation. (Stott, Davis 1979)

Acute Illness

Health promotion

Chronic disease

Modifying Help

Seeking Behaviour

The Exceptional Potential of Each General Practice

•Rural vs Urban

•Core vs Enhanced Practice

•The Primary Care Surgical Association

•Barriers to Enhanced Practice

Grange Clinic, Donaghmede

The Exceptional Potential of Each Consultation. (Stott, Davis 1979)

Acute Illness

Health promotion

Modifying Help

Seeking Behaviour

THE CORE ELEMENTS

The Exceptional Potential of the GP Practice

Acute Illness

Enhanced Practice

Occupational Health

Health Screening

Prison medical

Aeromedical

Events Medicine

Travel Medicine

Sexual Health

Addiction

Psychotherapy

Community Surgery

Emergency services

The Exceptional Potential of the GP Practice

Acute Illness

Chronic disease

NIDDM 430

COPD 252

Asthma 679

IHD

Hypertension 1452

Gout 260

HfeHC 52

Neuro/Psychiatry

......Prevalence Bedford Med Centre, Navan

The Exceptional Potential of Each General Practice

•Rural vs Urban

•Core vs Enhanced Practice

•The Primary Care Surgical Association

•Barriers to Enhanced Practice

Ardfert Medical Centre

The Exceptional Potential of Each General Practice

•Rural vs Urban

•Core vs Enhanced Practice

•The Primary Care Surgical Association

•Barriers to Enhanced Practice

5,900 Consultations

2,700 Telephone Consultations

2,500 Repeat Prescriptions

270 House calls

5,900 Consultations

2,700 Telephone Consultations

2,500 Repeat Prescriptions

270 House calls

CDM

5,900 Consultations

2,700 Telephone Consultations

2,500 Repeat Prescriptions

270 House calls

CDM

AUDIT

5,900 Consultations

2,700 Telephone Consultations

2,500 Repeat Prescriptions

270 House calls

PCT Meetings

Medical Council

CDM

HiQA

AUDIT

2002 2003 2004 2005 2006 2007 20080.0

20.0

40.0

60.0

80.0

100.0

120.0

140.0

160.0

180.0

DenmarkIrelandFranceNetherlandsUnited Kingdom

GPs/100,000 population Eurostat 2012

Hospital Physicians/100,000 population Eurostat 2012

2002 2003 2004 2005 2006 2007 2008 20090.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

DenmarkIrelandFranceNetherlandsUnited Kingdom

Abbey House Medical Centre, Navan

Hospital GP

DocPay

Doc Pension

Accomodation

Equipment

Nursing

Admin

Productivity. Bedford Medical Practice 2005-2011

2005 2007 2008 2009 2010 20110

1

2

3

4

5

6

7

8

Total PracticeIncome € millions

GMS list 1000s

6 6 6.5 7 7 7 7 No of GPs employed

Health gain as Investment Increases

Cost as Availability Increases

Investment >>>>

Availability >>>>

The rural GP

Outstanding in his own field