Decline in continuity of care across general practice in England

A STUDY of GP practices in England found an overall decline in continuity of care between 2012 and 2017.

Researchers in Leicester conducted an observational study in 6,243 primary care practices with more than one GP and calculated “patient-perceived relationship continuity” using two questions from the GP Patient Survey.

It found that relationship continuity declined by 27.5 per cent between 2012 and 2017 and at all socioeconomic deprivation levels.

Writing in the British Journal of General Practice, the researchers state: "Increased relationship continuity in primary care is associated with better health outcomes, greater patient satisfaction, and fewer hospital admissions. Greater socioeconomic deprivation is associated with lower levels of continuity, as well as poorer health outcomes."

The study set out to examine whether deprivation scores predicted variations in the decline over time of patient-perceived relationship continuity of care, after adjustment for practice organisational and population factors. It found that deprivation scores from 2012 did not predict variations but there was an overall decline.

Commenting on the study, Vice Chair of the Royal College of GPs, Professor Kamila Hawthorne said: "Continuity of care is at the heart of general practice and is highly valued by both patients and GPs alike – in fact, 80% of UK family doctors say it is one of the most essential components of general practice. We also know it can lead to better health outcomes for patients, and helps keep the NHS sustainable due to fewer hospital admissions.

"It's disappointing but understandable to read that, according to this paper, continuity of care is reducing, but GPs across the country are striving to provide continuity, even if not in the traditional sense. Some practices, for example, are using innovative approaches to continuity of care whereby patients might not always see the same GP, but they will see, and build relationships with, one of a small team who will all have access to their medical records.

"The RCGP has developed a toolkit for general practice teams to support them to deliver continuity of care against a backdrop of changing patient needs, and significant resource and workforce challenges. But ultimately, we urgently need NHS England's GP Forward View – which promises an extra £2.4bn a year for general practice and 5,000 more GPs by 2020 – delivered in full, so that we have the resources and workforce to provide the care our patients need and deserve, tailored to their specific needs."