Acute Disease

An acute disease or condition is one that generally has a rapid onset and/or lasts only for a short time. Such diseases or conditions can generally be treated and cured. An example would be an acute infection.

Advanced Care Plan

Advanced care planning is a process enabling a patient to express wishes about his or her future health care in consultation with their health care providers, family members and other important people in their lives. Based on the ethical principle of patient autonomy and the legal doctrine of patient consent, an Advanced Care Plan helps to ensure that the concept of consent is respected if the patient becomes incapable of participating in treatment decisions.

Bucks Urgent Care (BUC)

Buckinghamshire Urgent Care is a partnership between experienced out-of- hours providers and local GPs, launched in November 2009.  As well as a new GP out-of-hours service, BUC now also provide the innovative new GP-led Wycombe GP Health Centre, opened on the Wycombe Hospital site. This provides bookable and walk-in GP services for patients from 8.00am to 8.00pm, whether or not they are registered with a doctor. BUC is aiming to ensure that local people receive the right care at the right time, and in the right place.

Chronic Disease

This is an illness or condition that is long-lasting in nature or has a frequent recurrence. Such diseases can generally be controlled but not cured. Examples include diabetes, heart disease, chronic obstructive pulmonary disease etc.

Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. The main symptom of COPD is an inability to breathe in and out properly. This is also referred to as airflow obstruction. Airflow obstruction is caused by long-term damage to the lungs, usually as a result of smoking.

Circulatory Disease

This is a disease that affects the circulation of the blood in the heart, arteries, capillaries or veins.

Collegiate Working

This is the term used to describe how local GPs, with a special interest and expertise in a particular medical condition, can assist their colleagues within BPCC to manage a specific patient’s care by providing advice or treatment on request.


Commissioning is the process of assessing the needs of a local population and putting inplace services to meet those needs.


This is a list of preferred drug products that is provided to assist a GP in choosing between the most effective medicines for treating a particular condition.

Glycaemic Control

Diabetes is a long-term (chronic) condition caused by too much glucose (sugar) in the blood. It is also known as diabetes mellitus. Normally, the amount of sugar in the blood is controlled by a hormone called insulin, which is produced by the pancreas (a gland behind the stomach). When food is digested and enters your bloodstream, insulin moves any glucose out of the blood and into cells, where it is broken down to produce energy. However, in those with diabetes, the body is unable to break down glucose into energy. This is because there is either not enough insulin to move the glucose, or because the insulin that is there does not work properly.  Glycaemic control is the process used to regulate the level of sugar in the patient’s blood either through diet, tablets or administration of the drug insulin.

Health Economy

A term used to embrace all the organisations, NHS and others, whose activities have an effect on people’s health in a local area. As well as the NHS it can include local authority functions such as social services, environmental health and transport, and housing associations

Health Indicators

These are measures that reflect or indicate the state of health of people in a defined population. They may also identify potential or suspected problems or risks as they relate to the environment. Examples would include, infant mortality rate, incidence of heart disease, prevalence of smoking, levels of obesity etc.

Health Outcomes

This is used to describe the effect on a patient’s health from carrying out (or not carrying out) one or more treatments or activities by healthcare providers.

Intergrated Care Organisation (ICO)

This describes a vision, rather than a precise organisational structure, that seeks at a local level to transform fragmented services in the NHS into seamless, integrated care, through partnership between GPs and other providers of health and social care. Replacing the boundaries that separate budgets, GP surgeries, Hospitals, Social Services and others, with seamless care pathways where objectives are aligned and all members equally informed, will result in better patient care and results. The concept can be summarised as, ‘One Service, One Team, One Budget’.

NHS Buckinghamshire

NHS Buckinghamshire is the name of the Primary Care Trust (see below) for Buckinghamshire. It is the body responsible for planning and securing quality healthcare services, reducing inequalities and improving the health of the local population. It works with various NHS agencies in Buckinghamshire to provide services closer to home. It also leads on other NHS services with GPs, dentists, pharmacists, optometrists, ambulances and hospitals. For more information visit www.buckspct.nhs.uk.

Practice Based Commissioning (PBC)

Commissioning simply means deciding what services you want to buy and buying them. In our context this is all about identifying, planning and meeting patient healthcare needs. It is the process by which:

  • the health needs of a population are assessed 
  • the responsibility is taken for ensuring that appropriate services are available to meet these needs (including meeting any national or local NHS requirements) 
  • the accountability for ensuring the quality and effectiveness of the services is made clear

Practice Based Commissioning (PBC) is a government initiative that started 5-6 years ago. It is about putting GP practices and other health and primary care professionals at the heart of the commissioning process, so that the clinical requirements of what patients need are put first. It transfers the responsibilities set out above from NHS Bucks to your local GP practices.  With patient involvement, they will determine the range of health services to be provided within available financial resources whilst NHSB retains control of the budget and acts as their agent to purchase the services and to carry out the associated administrative tasks.

The intention is that through PBC, those who have direct responsibility for providing you with healthcare are provided with the resources and support to become involved in deciding what services will best meet your needs. There has been criticism of the speed of take up of PBC (what others might see as speed of letting go by managers), but the major political parties agree that it is here to stay that it also needs to be developed further. 

It is intended that full implementation of Practice Based Commissioning will lead to high quality services for patients in local and convenient settings. GPs, nurses and primary care professionals are in the prime position to translate patient needs into services that are designed to best deliver what local people want.

For further details on practice based commissioning please visit The Department of Health website.

Primary Care

This is healthcare that is offered in the community and not in hospitals or specialist centres. It includes the range of family health services provided by doctors, dentists, pharmacists, optometrists and ophthalmic medical practitioners, practice nurses, health visitors and allied health professionals.

Primary Care Clinician

A health care professional who works in primary care. This would include doctors, dentists, pharmacists, optometrists and ophthalmic medical practitioners, practice nurses, health visitors, etc.

Primary Care Trust

Primary care trusts are bodies created within the NHS who are tasked to ensure high quality healthcare services are available to local residents, develop patient choice and involve local people more in their care and treatment. They are also responsible for improving the health of the local population and reducing inequalities. The Primary Care Trust for Buckinghamshire is called NHS Buckinghamshire (NHS Bucks).

Psychological Therapies

This is a term used to describe a range of treatments that that can often prove useful in treating emotional problems and mental health conditions such as:

  • depression, 
  • anxiety, 
  • obsessive compulsive disorder (OCD), and 
  • post-traumatic stress disorder (PTSD). 

These can help the patient to understand and accept their strengths and weaknesses, as well as identifying what makes them feel upset, depressed, or anxious. Examples of psychological therapies would include counselling, psychotherapy and cognitive behavioural therapy (CBT).

Secondary Care

Secondary care is a term used to describe the service provided by medical specialists who generally do not have first contact with patients, for example, cardiologists, urologists and dermatologists. In particular this is used to describe the care provided in hospitals.

Social Care

This term refers to care services which are provided by local authorities to their residents, or which are commissioned by local authorities. Examples include, social services, children’s’ services, care homes for the elderly etc.


Cholesterol lowering drugs.

Stoma Care

A stoma is an artificial opening on the abdomen to collect waste (either faeces or urine). Stomas to collect faeces connect to the bowel (intestine); stomas to collect urine connect to the ureter (the tube that carries urine from your bladder to your kidneys). The waste products are collected in a reservoir bag, or pouch, on the outside of the body. Stoma Care in the community is usually provided by a Stoma Care Nurse who will assist the patient to choose the most suitable appliances for their stoma and support him or her in their usage.

Strategic Health Authority (SHA)

NHS strategic health authorities (SHA) are part of the structure of the National Health Service in England. Each SHA is responsible for enacting the directives and implementing financial policy as dictated by the Department of Health at a regional level. In turn each SHA area contains various NHS trusts which take responsibility for running or commissioning local NHS services. The SHA is responsible for strategic supervision of these services. The SHA for Buckinghamshire is NHS South Central.

Vulnerable Patients

We use this term to describe patients who, because of long term, chronic health conditions, are more at risk of suddenly being admitted to hospital. By identifying such patients and seeking to better manage their care and treatment within the community, the aim is to reduce the need for such emergency admissions.