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The latest Governments primary care white paper Our health, our care, our
say: a new direction for community services shows further support for the
development of Practitioners with special interests (PwSIs), practice-based
commissioning and community hospitals. Yet issues of training, accreditation,
continuing professional development and remuneration remain unclear. At an
individual level, these areas are highly relevant and topical. Through these
constantly changing NHS times, we hope to bring some clarity and guidance on
these more practical matters, not only through this journal, but more so through
the open forum on our website www.apwsi.co.uk. The Association of
Practitioners with Special Interests (APWSI) is expanding steadily, and our 3rd
annual conference “Enhancing the delivery of healthcare” is a further opportunity
to tackle these hot topics in a more personal and interactive arena.

In this issue, Drs Peter Stott and Anne Hollings, Medical Directors of EDICS
(Epsom Downs Integrated Care Service), one of the largest practice based
commissioning groups in the UK, give us a valuable insight into the broad role
that a GPwSI can provide. For those medical professionals out there who still
think that GPwSIs are glorified and better paid clinical assistants, then we hope
that this article will persuade them otherwise. It is well recognised that it takes
years of training to become a secondary care specialist. GPs working at an
intermediate level of healthcare have more of a role to play than just increasing
service capacity. That is not to say that with appropriate case selection and
support, a significant case load cannot be dealt with effectively. However, GPs
have always been best placed to understand their patients needs, and now the
opportunities to manage and run more patient-centred services, closer to home,
are becoming more readily available.

Increasing numbers of hospital consultants are forming professional chambers
and offering their services to commissioning groups. In some areas, it has been the
GPs who have set the Chambers up, working with a whole range of independent
practitioners, albeit mostly consultants.1 This is likely to expand further as
Foundation Trusts go live nationally and GPs compete with other private
providers, as the market to commission services opens up even more. Watch this
space!

1. The GPs in chambers. MedEconomics. December 2005.