Some aspects lend themselves to the mini-clinic approach

General practice p 550

In 1979 Stott and Davis identified the four areas of exceptional potential to serve patients in every primary care consultation, which included management of continuing problems along with management of the presenting problem, opportunistic health promotion, and modification of help seeking behaviour.1 However, we now know that chronic diseases are often more effectively managed through special clinics outside routine consultations, usually staffed by practice nurses. Such “mini-clinics” have been shown to improve the outcome of asthma2 and diabetes3 and are now widespread in British general practice, encouraged by separate payments for chronic disease management. Might this approach also be applied to depression?

For many patients depression is more accurately considered a chronic relapsing condition, rather than a series of discrete episodes, and, as for other chronic conditions, there are concerns about how it is managed in routine consultations. Leaving …