Seeing your preferred GP is getting more difficult

Posted by pt91 at May 09, 2018 09:50 AM |
University of Leicester research identifies a large decline in continuity of care over five years

Issued by University of Leicester on 9 May 2018

Continuity of care – the long-term professional relationship between a patient and a chosen GP - is not only at the core of general practice but is recognised as being associated with better recognition of certain health problems, better concordance with medication, better uptake of preventive services and more cost-effective use of healthcare resources.

A new research study by Louis Levene and colleagues from the University of Leicester looked at 6243 primary care practices with more than one GP in England. It is published in the British Journal of General Practice.

The two main findings of this study are:

  • Continuity, defined in this study by patients' answers to two GP Patient Survey questions about being able to choose and to see a preferred GP, fell by over one quarter in England during the period 2012 to 2017.
  • This marked decline was widespread and variations between practices were not predicted by socio-economic deprivation or other population and organisational factors.

Dr Levene, from the University’s Department of Health Sciences, said: “Continuity of care (being able to see a preferred GP) helps many patients, but it has declined markedly in the last 5 years, an unintentional and inevitable casualty of the mounting workload pressures faced by general practices across England.

“Our study has shown that this decline is not linked to areas of poverty; it is slightly better for non-white ethnicity and slightly worse if elderly, living in the North or having a long-term condition.

“The recent changes to GPs’ contracts which aim to improve continuity have not worked so far. Continuity will improve only if its causes are tackled and the measures taken include sufficient resources being added or re-directed, so as to avoid harming overall patient care.”

The contractual requirement for patients to have a named doctor has, so far, not altered this steady decline in continuity, which coincides with longer waiting times for GP appointments, suggesting that workload pressures are, once again, creating problems for the doctor-patient relationship.

How much decline is due to workload, part-time doctors, or other factors? More detailed work within practices is needed. The Royal College of General Practitioners has produced a continuity toolkit to help practices measure continuity and to try to improve it.

Improving continuity is unlikely to occur until its causes are fully identified, and the measures implemented to address these causes are feasible for individual practices without detriment to overall service delivery. It is unlikely that continuity will improve until its causes are fully identified, and the measures implemented to address these causes are feasible for individual practices without detriment to overall service delivery.

The study was carried out by Louis S Levene, Richard Baker, Nicola Walker, Christopher Williams, Andrew Wilson and John Bankart from the University of Leicester Department of Health Sciences.

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