|The doctor tends to see patients mainly as presenting medical problems for the doctor’s advice. He or she does not always make use of community resources, either professional or self-help and support groups.
||The doctor knows the full range of resources available in the practice and the community. Patients are appropriately (1) referred to nursing, social services and/or voluntary bodies for help.
|Has little understanding of this.
||Attempts to do this but is not yet skilful and sometimes runs into difficulty.
||Attempts to do this and is usually successful but recognises his/her limitations.
||Respects and is prepared to defer to the community nursing sister in discussing the nursing care of patients, and the health visitor for preventive matters.
||Values the help that social workers can give, and respects their professional autonomy.
||Balances the patient’s right to confidentiality with a colleague’s need for information.
||Encourages patients to join appropriate self-help groups (eg British Diabetic Association, Alcoholics Anonymous).
Notes for raters
(1) Appropriately means
- to the person or agency with the right skills and resources (eg, wrong to ask health visitor or district nurse to take on something better done by a social worker) and
- after getting a mandate from the patient for the referral (so that he or she does not feel fobbed off).
This area of behaviour is best assessed by observation in team meetings, getting opinions from the other professionals and case discussion.