Primary care, secondary care, tertiary care, social care. This list of medical terms is thrown around in interviews is long and it doesn’t look good if you have to ask “what does that mean?”. Although it’s perfectly legitimately for you to have not come across these terms during your various work experience placement, its far better to understand them ahead of the interview. Also, using these terms in your answers will be sure to impress (just make sure you use them correctly). This blog covers a few of the essential terms, their definitions, and examples in which they might be used (or in which you could use them).
Ok, let’s start with primary, secondary and tertiary care – ones that gets used a lot. This system describes the hierarchy of care in the NHS and the usual flow of patients through it. Primary care describes the first point of contact – usually GP. This is where the majority of patients are seen and treated. It’s a very important area to be aware of as GPs are seen as the ‘gate-keepers’ of healthcare, deciding who should and shouldn’t receive further investigations or treatment. Also, many argue that this area is underfunded as it’s an area of catching diseases before they need treatment (just think about how much it costs to have a patient stay in hospital compared to seeing their GP).
In a nutshell, secondary care is hospital care. Usually patients are referred to hospitals by GPs for further management (IE the hospital is the second point of care). An important exception to this schema is A&E, where patients present directly to secondary care. Patients in secondary care will often have a short stay in hospital for treatment. Following this, tertiary care describes more specialist hospital care which is often more long-term. Operations and chemotherapy would fall into this category. There is also quaternary care which is just even more specialised, niche and sometimes experimental, but don’t worry about that.
Another type of care worth knowing, and discussing in your interview, is social care. This describes non-doctor care in the community for ‘social’ issues. Examples of this would include health visitors, nursing homes and other services that support people in everyday life. This is particularly hot topic as social care cuts have had a knock-on effect to secondary care. The A&E crises that seem to roll around each winter are argued to be the direct effect of reductions in social care. In many hospitals, elderly patients are unable to be discharged due to a lack of facilities to support them once they leave – ie they need more support in day-to-day life so can’t return home. This means these patients remain on the wards.
This has several knock-on effects. Firstly, it means new patients cannot be brought onto the wards from A&E, leading to increases in A&E waiting times (remember the large number of news stories about A&E waiting times in the winter of 2014). Secondly, it leads to the cancelling of non-emergency operations as there are not enough spaces on wards. This leads to longer waiting times for operations like hip replacements and laproscopic cholecystectomies (gall-bladder removal), and very unhappy patient who are in a lot of pain. Thirdly, it costs a lot to keep people in hospital – more than in a care home, or their own home.
So, there we have it. A brief summary of the structure of the health service and the essential terms you need for your interview. Best of luck everyone.