Differences between Germany and the UK
In Germany, many medical practitioners still work alone in single-handed practices. In the UK, group practices are the norm. Specialists are available only in hospitals, where they also provide ambulatory care. Patients must first consult their GPs (primary care), who then decide whether a referral is necessary. GPs are likely to apply fairly strict criteria for referrals, as waiting times for specialist appointments (secondary care) are often very long.
Until 2004, GPs – at least on paper – were responsible for their patients 24 hours a day, 365 days a year. GPs needed to be available but could delegate responsibility to another doctor. Today, GPs are responsible for their patients only on weekdays from 8 am to 6 pm. Care outside these hours can be transferred to other doctors (“out of hours”). However, the British government has recently made calls for GP surgeries to be open seven days a week.
In contrast to Germany, British GPs more often work in a team with other healthcare professionals such as practice nurses, community nurses, physiotherapists, social workers, midwives, and health visitors. For example, GP practice nurses often run their own clinics for chronically ill patients, such as those with asthma or diabetes. District or community nurses work largely independently, visiting patients at home and providing care to elderly and frail patients.