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The growing volume of diabetic care taking place in UK general practice and pressure to unload hospital clinics are resulting in entirely separate patient caseloads, in which structured care and monitoring of large numbers of patients over many years can take place in one health care sector alone. In these circumstances, it is important to guard against the GP service becoming educationally and clinically isolated from hospital diabetic clinic care and vice versa. Greater interplay of staff between health sectors could serve as an antidote. Educational objectives for brief SpR secondment to general practice diabetic clinics were formulated and three month SpR secondment to a central London practice clinic was set up and judged a success for GP and SpR alike. This was followed by GP and consultant sitting in on each other's diabetic clinics, allowing each to appreciate similarities and differences in their clinic, case load and practice setting.

Dialogue and interchange across the primary/secondary interface: piloting SpR secondment to a general practice diabetic clinic