GP continuity of care linked with lower death rate, study shows

Continuity of care is directly linked with fewer deaths among patients, researchers have found, prompting the RCGP to renew calls for 'more GPs and more resources'.

GP consultation (Photo:
GP consultation (Photo:

Research by the University of Exeter's medical school analysed 22 studies - all of which examined the relationship between continuity of care and death rates. Of these, 18 (82%) concluded that repeated contact with the same doctor over time resulted in ‘significantly fewer deaths’ among patients.

Professor Philip Evans, of the University of Exeter medical school, said: ‘Continuity of care happens when a patient and a doctor see each other repeatedly and get to know each other. This leads to better communication, patient satisfaction, adherence to medical advice and much lower use of hospital services.

'As medical technology and new treatments dominate the medical news, the human aspect of medical practice has been neglected. Our study shows it is potentially life-saving and should be prioritised.’

The findings, published in BMJ Open back up research published last year, which showed continuity of care halved the risk of emergency hospital admissions. It also follows widespread coverage on Thursday of claims from a health technology firm that artificial intelligence (AI) computer systems can outperform GPs in elements of the MRCGP test.

Sir Denis Pereira Gray, a GP who collaborated on the study, added: ‘Until now, arranging for patients to see the doctor of their choice has been considered a matter of convenience or courtesy: now it is clear it is about the quality of medical practice and is literally a matter of life and death.’

Workforce pressures

However, despite evidence of the benefits of continuity of care, data show that an under-pressure NHS is struggling to deliver it. Last month, figures published in the British Journal of General Practice (BJGP) found that levels of continuity of care delivered by general practice in England had fallen by more than 25% in just six years.

‘General practice is currently facing intense resource and workforce pressures, which is making it increasingly difficult for patients to access our services and unfortunately, waiting to see ‘their’ GP means patients may have to wait even longer for an appointment,’ said RCGP vice chair Professor Kamila Hawthorne.

‘Balancing continuity of care with timely access to GP services is a huge challenge for general practice, and ultimately the answer is more GPs and more resources for the profession.

She added that practices should consider using ‘innovative approaches to retaining continuity of care’, such as ensuring patients build a relationship with a whole team of healthcare professionals rather than just one GP.

‘NHS England has already pledged £2.4bn extra a year for general practice and 5,000 more GPs by 2020 - and this must be delivered to safeguard the future of general practice and patient care,’ she concluded. ‘Resilient general practice is essential to the long-term viability of our NHS and to the health of our nation.’

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