A survey of GPs and practice nurses at 22 practices in England in February and August 2007 showed that some GPs saw the contract as accelerating a decline in interpersonal continuity of care.
One GP said that patients presented with the same problems, but that it was 'more likely that the patient and the doctor won't know each other'.
But nurses are finding they are becoming more involved in continuity of care as they take responsibility for patients with long-term conditions. Both GPs and nurses said that nurses have become the primary providers of healthcare for those with chronic conditions, with some GPs fearing that their profession was becoming 'deskilled'.
The framework has altered dynamics between GPs and their patients, say the researchers from the National Primary Care Research and Development Centre.
Comment below and tell us what you think