Patients who attend the same GP are more likely to build a trusted relationship with them, and take their advice – but only 52% of patients can revisit the same GP
Patients who can attend the same GP have been proven to have better health experiences, where they take more advice and health action, as well as those with long-term health conditions, are better off too.
“In addition to improving clinical outcomes, this is likely to have a positive effect on satisfaction for both patients and doctors”
According to Queen Mary’s Clinical Effectiveness Group (CEG), as continuity of care is in decline, patients who do not attend the same GP could be disproportionately affected, leading to less efficient care and important issues being missed.
Sadly, only 52% of patients can see their practitioner again, which means only half the population can attain better patient outcomes, particularly for people who are elderly, have complex, long-term or multiple conditions, or have poor mental health.
Patients who see the same clinician have fewer hospital admissions and lower mortality rates
Researchers analysed the care of 1 million adults registered at 126 GP practices in East London and found that only half of the patients regularly see the same GP, at 52%.
It is possible to measure continuity of care simply: The researchers used data from two sources – the annual General Practice Patient Survey (GPPS) and the Usual Provider of Care (UPC) index – to measure continuity of care in East London. This information is already routinely collected.
From this, they were able to find that patient age and practice size were the strongest predictors of continuity of care – so the older the patient, the more likely they were to see the same GP. But the larger the practice, the less likely.
Continuity of care has been steadily declining, with reasons including the expansion of larger practices, an increase in the number of GPs working part-time, recruitment difficulties, and a prioritisation of rapid access over continuity.
Further affected by the pandemic, COVID-19 amplified many of these factors and has changed the way that patients interact with their local practice.
Measuring continuity of care as a marker of practice quality
Dr Sally Hull, the lead author and Clinical Reader in Primary Care Development at the Queen Mary University of London, said: “Continuity of care leads to better outcomes, particularly for elderly patients and those with complex needs, and it should be measured routinely as a marker of practice quality. We have shown that it is possible to measure continuity simply, across a whole health economy, using information that is already routinely collected.
“Improving continuity of care will require incentivisation and engagement from the emerging primary care networks and integrated care systems. There are also opportunities for local initiatives, such as the development of micro-teams within larger practices, or changes to booking systems, but these would need to be underpinned by reliable monitoring.
“With incentivisation and monitoring in place, it is possible to improve continuity of care. In addition to improving clinical outcomes, this is likely to have a positive effect on satisfaction for both patients and doctors. We hope that the Health and Social Care Committee will consider this in their current inquiry into the future of the general practice.”
Continuity is not currently measured or incentivised by health policy, but the Health and Social Care Committee (Commons) have made continuity of care a focus of their inquiry into the future of General Practice.
