General practice: what a GP does, when to go and how referral to specialists works

A GP is a doctor trained in the whole range of everyday medicine: infections, injuries, skin problems, mental health, women and men health, children, older people, and the ongoing care of long-term conditions. NHS Health Careers describes GPs as treating all common medical conditions and referring patients on, and as caring for people with chronic illness to keep them well and, where possible, in their own homes.

GPs work with practice nurses, pharmacists, physiotherapists, mental health practitioners and others in the same surgery, so your first contact may be with another professional. Many consultations can be done face to face, by phone or by video.

Training follows medical school, a two-year foundation programme with six placements, then a minimum of three years of specialty training in general practice, according to NHS Health Careers. After this, GPs can develop a special interest, such as diabetes, sports medicine or palliative care.

High blood pressure is one example of a condition mostly found and managed in general practice. The NHS says many pharmacies offer free blood pressure checks for people aged 40 or over, and that you are usually considered to have high blood pressure at 140/90 or higher in a clinic. Type 2 diabetes is diagnosed with a blood test and followed up by regular reviews, with the NHS noting that a GP, nurse and wider diabetes care team are involved.

Common mental health problems such as depression and anxiety are mostly assessed first by a GP, who can discuss talking therapies, medicines and referral. Other everyday work includes minor injuries, coughs and chest infections, rashes, urinary symptoms, contraception, menopause symptoms and sexual health, with antibiotics only prescribed when needed. The NHS says, for example, that antibiotics are not normally prescribed for coughs.

The NHS Health Check is a free check of heart and blood vessel health for people aged 40 to 74 who do not have conditions such as heart disease, diabetes or high blood pressure. It includes blood pressure, cholesterol and possibly blood sugar, produces a 10-year cardiovascular risk score and is offered every 5 years by your GP or local council. If you have not been invited and think you are eligible, the NHS suggests asking your GP practice.

GP services also include childhood vaccinations, and travel advice and some vaccines for trips abroad. Some vaccines and tests, for example those for travel or those not covered by NHS schedules, may be offered privately at a cost, so check which are free and which are not before you proceed.

The NHS says everyone in England can register with a GP surgery or change their surgery for free, most surgeries accept online registration, and you normally need only name, date of birth and address. A surgery may refuse if it is not accepting new patients, you live outside its area or you were removed from its list before, and if it refuses it must write to you within 14 days to explain. You can register as a temporary patient for up to 3 months, and if refused you can still receive immediately necessary treatment for up to 14 days.

The NHS App can be used to book appointments and view test results for registered patients in many surgeries, and many surgeries offer an online form to contact the practice.

The NHS says you are entitled to ask for a referral, but whether you get one depends on what the GP feels is clinically necessary, and that a GP will probably suggest trying tests or treatment first. A specialist will only see you with a referral letter, which carries your history. If referred, you may have the right to choose which hospital in England to go to for the first outpatient appointment, and the NHS Constitution gives a right to start consultant-led treatment within 18 weeks for non-urgent conditions, unless waiting longer is your choice or clinically right.

For an urgent suspected cancer referral, the NHS says cancer should be confirmed or ruled out within 28 days, with an appointment or tests often within 2 weeks. If you want to see a private specialist, the NHS still advises asking for a GP referral letter, and says your GP is not obliged to accept the private specialist recommendations.

Private GP services are paid for directly or through insurance or an employer. They differ between providers in appointment length, how soon you can be seen, which tests and scans are available on site, how results are shared and whether prescriptions are issued privately. They do not replace your NHS GP record, so it helps to share summaries with your registered surgery.

Costs depend on the appointment type and length, blood tests, imaging, vaccines and any follow-up, so ask for itemised prices in writing. Services such as multi-cancer blood tests or broad screening panels are not part of NHS routine care, and their value should be discussed carefully with a clinician before paying.

• Write down your symptoms, when they started, what makes them better or worse and anything you have already tried.

• List all medicines, including those bought without a prescription, and any allergies.

• Say if you have diabetes, since the NHS says foot problems can be more serious with diabetes.

• Use NHS 111 for urgent problems that are not life threatening, such as a cough that is quickly worsening or severe tiredness with other worrying symptoms.

• Call 999 for chest pain that does not go away, pain spreading to the arm, neck or jaw, difficulty breathing, or signs of stroke.