What is secondary care?

National Health Service (NHS) care is provided in two main ways: primary care (GPs and community services) and secondary care (hospitals and specialists).

Primary care is the first place people go to when they have a health problem and includes a wide range of professionals, e.g., GPs, dentists, pharmacists and opticians.

Secondary care simply means being taken care of by someone who has particular expertise in whatever problem a patient is having. It’s where most people go when they have a health problem that can’t be dealt with in primary care because it needs more specialised knowledge, skill or equipment than the GP has. It’s often provided in a hospital. The GP will decide what kind of specialist the patient needs to see and contact them on the patient’s behalf to get them an appointment – this is called a ‘referral’.

A GP explains what primary and secondary care is.

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Before we begin can you tell us a bit about what’s the difference between primary care and secondary care and where GP’s fall under this?

Okay. So primary care is basically the people you go to first, so that’s GPs, pharmacists, nurses, also actually includes opticians and dentists, they all come under primary care’s. Secondary care’s is care offered by specialists usually up in hospitals and usually you’sd be referred to secondary care from someone in primary care.

Okay, so I’m guessing a patient would have to go through primary care first before they can be seen in secondary care?

That’s usually the case, yes. So your GP, if you needed specialist treatment or some service that’s not available in primary care, would refer you to secondary care.

And where does A&E land in these categories?

Yes A&E is kind of in the border really because it’s at the hospital but it does count as a hospital service so, it counts as secondary care.

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What do secondary care doctors do?
Specialists in secondary care focus either on a specific part of the body or body system, disease or condition. For example, cardiologists focus on the heart and its pumping system. Endocrinologists focus on hormone systems and some specialise in diseases like diabetes or thyroid disease. Oncologists work on cancers.

Where are secondary care doctors based?
Secondary care services are usually based in a hospital or clinic rather than the community. Sometimes ‘secondary care’ is used to mean ‘hospital care’ but not all secondary care professionals work in hospitals, such as psychiatrists and some clinical psychologists and occupational therapists.

What does secondary care include?
Secondary care includes treatment for illness, injury or other health problem in hospital or in an outpatients’ clinic. It also includes tests and care for serious conditions. No one needs a GP referral if they need to use Accident and Emergency (A&E) for a serious, urgent problem – but many problems can be dealt with by GPs even when the surgery is closed.

A small number of hospitals provide what is called ‘tertiary care’, which means the third level of care. This is where hospitals, such as Great Ormond Street for children, look after patients sent to them by other hospitals for highly specialised care.

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