When I first started in general practice in 1990 I worked with a general practice nurse (GPN), a health visiting team, a district nursing team, a community psychiatric nurse (CPN), a social worker and a benefits advisor, and we were accountable for the 24/7 expert generalist cover for our registered list of 8,500 people.

 I entered general practice after a decade of training and experience as a general and vascular surgeon and it took me some while to adjust to the shock of realising that my mindset, attitudes and beliefs, drummed into me through medical school and beyond, had to be reframed: I had to become an expert generalist.