Killick Street Health Center (03:06)
Dr. Rachel Hopkins is a GP at a London primary care center serving 10,000 patients. Monday afternoons are baby clinics. During her residency in the U.S., she was shocked by children receiving inadequate care due to high insurance costs.
National Health Service Model (04:09)
Britain set up the NHS in 1948 to provide universal care. Primary care is critical to the system, serving most patients and saving taxpayer money. A nurse practitioner treats George for lower leg edema and eczema, an ongoing condition.
Long Term Doctor-Patient Relationships (04:45)
Primary care helps U.K. citizens trust their doctors. Hana has mental health issues and considers Dr. Melissa Gardner a friend, as well as a healthcare provider. Dr. Gardner uses listening and empathy skills to build Hana's self-confidence.
Primary Care Referral System (03:35)
Patients must visit GPs before seeing a specialist, saving money by keeping them out of hospitals. Each appointment is scheduled for 10 minutes and costs the NHS £31. Doctors are pressured to use referrals judiciously; Dr. Ben Smith rejects a request for a nerve pain specialist.
Monitoring Referrals (02:16)
Referrals have increased in England over the last seven years. Clinical groups provide guidelines for GPs to ensure best medical practices, such as recommending cheaper medications to cut NHS costs.
Pressure on the NHS (04:07)
By saving resources, GPs can spend more time on serious cases. Dr. Smith visits a patient suffering a rare skin disease and prescribes morphine and amitriptyline— expensive pain medications. Meeting the medical needs of the growing and aging U.K. population is a challenge.
Business Side of Primary Healthcare (03:20)
The NHS contracts general practices that receive $117 per patient annually. Killick Street Health Center doctors hold their annual financial meeting. The national budget primary healthcare allocation is shrinking; recent regulations mean senior GPs will lose money
Healthcare Front Line (02:23)
GPs train for 10 years and can be paid an equivalent salary to hospital specialists. Dr. Hopkins worries about missing dangerous symptoms. Fashion journalist Harry's previous GP refused to refer him to a specialist; he has since been diagnosed with cancer.
Treating Alcoholism (03:34)
GPs provide care previously given by hospitals, including mental health and substance abuse. Michael sees a counselor about his alcohol dependency.
Caring for an Aging Population (03:47)
William is a full time caregiver for his wife, a stroke victim. He recently suffered a chest infection and is physically unable to continue care giving. Dr. Smith refers him to a specialist.
Keeping Patients out of Hospital (03:11)
Primary care providers manage co-morbidities common in elderly patients. Senior nurse Linda Staines tries to determine whether a patient's diet is affecting the effect of Warfarin on his blood. Getting patients to take responsibility over their health is a challenge.
Shrinking GPs (03:31)
Primary care doctors have the lowest morale of the NHS; fewer are training to replace those retiring. The financial crisis has put an extra strain on the system. Michael has stopped drinking with support from his GP, but Dr. Smith's patient Lucy succumbs to her illness.
Compassionate Care (04:03)
Dr. Yellon visits Parkinson's patient Nguyen at home; his grown children provide palliative care— saving the NHS money. Despite challenges, the primary healthcare model is held up around the world. Dr. Hopkins reflects on 17 years of practice.
Credits: UK’s Frontline: The People’s Health (00:29)
Credits: UK’s Frontline: The People’s Health
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