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Only half of patients regularly see the same GP

Joint research between King’s and QMUL found that only 52% of patients regularly have their appointments with the same GP, despite increasing evidence that continuity of care between GPs and patients leads to better health outcomes.

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Continuity of care with GPs has been associated with better patient outcomes, particularly for people who are elderly, have a complex, long-term or multiple condition(s), or are of ill mental health. Patients with continuity of care also have fewer hospital admissions, lower mortality rates and are more likely to follow advice and build a trusting relationship with their GP.

Dr Mark Ashworth and Dr Peter Schofield were involved in a joint publication by King’s College London and Queen Mary University of London (QMUL) that analysed the data of 1.1 million adults at 126 GP practices in East London. The study used data from the General Practice Patient Survey (GPPS) and the Usual Provider of Care (UPC) index to measure the continuity of care received by patients.

Only half of patients regularly see the same GP, despite increasing evidence that continuity of care between GPs and patients leads to better outcomes, particularly for patients with Long Term Conditions or Multimorbidity.– Mark Ashworth, Reader in Primary Care, School of Life Course & Population Sciences

Results found that 52% of patients regularly see the same GP and that patient age and practice size were the strongest predictors of continuity of care, with older patients being more likely to see the same GP while patients at larger practices were less likely.

The authors provide multiple reasons for declining trends in continuity of care including: the expansion of larger practices, an increase in GPs working part-time, recruitment difficulties, and a prioritisation of rapid access over continuity. Many of these factors have been exacerbated by the pandemic.

The researchers are calling on policymakers to measure continuity of care as a marker of GP practice quality, with incentives to encourage improvement. This metric would be more aligned to vocational values of GPs than many of the QOF indicators in current use; we would like to see widespread use of a continuity of care indicator, as used in our study.– Mark Ashworth, Reader in Primary Care, School of Life Course & Population Sciences

The publication also highlights how simple it is to collect data on the continuity of care, as GPPS and UPC index data are already routinely collected. Though public health policy has traditionally disregarded continuity of care as a marker of GP practice quality, the Health and Social Care Committee (in the House of Commons) have made continuity of care a focus of their inquiry into the future of General Practice.

Read the full paper: Measuring continuity of care in general practice: a comparison of two methods using routinely collected data.

In this story

Mark  Ashworth

Mark Ashworth

Professor of Primary Care

Peter  Schofield

Peter Schofield

Senior Lecturer in Population Health