'Life-saving' continuity of care at risk in the UK, GPs warn

Continuity of care in general practice reduces use of out-of-hours care, acute hospitalisations and mortality, researchers have shown - as GP leaders warned staff shortages and heavy workload means it is becoming harder to deliver in the UK.

GP consultations (Photo: Robert Johns/UNP)
GP consultations (Photo: Robert Johns/UNP)

Long-lasting personal continuity with a GP is 'strongly associated with reduced need for out-of-hours services, acute hospitalisations, and mortality', according to a study by researchers in Norway.

An association lasting more than 15 years between a patient and a specific GP reduces the probability of any of these factors by 25-30%, the study published in the British Journal of General Practice found.

The researchers said 'promoting stability among GPs' should be a priority for health authorities, and warned that continuity of care was under pressure.

Continuity of care

The findings come as general practice in the UK faces intense pressure amid a shortage of GPs and intense workload after more than 18 months of the COVID-19 pandemic.

Responding to the findings, RCGP chair Professor Martin Marshall said: 'Continuity of care is highly valued by patients and GPs and our teams alike. It is what allows us to build relationships with our patients, often over time, and this study builds the strong evidence base of its benefits for patients and the NHS.

'Delivering continuity of care is becoming increasingly difficult as GPs and our teams struggle to deal with intense workload and workforce pressures – and the need to prioritise access to GP services. However, GP teams strive to deliver continuity of care in innovative ways, such as working to build trusting relationships between different members of the practice team, not just the GP.'

Professor Marshall warned that building the GP workforce as a matter of urgency was vital - urging the government to 'make good on its promise of 6,000 more GPs and 26,000 more members of the practice team'.

GP workforce

Professor Marshall said: 'General practice urgently needs more GPs and more members of the practice team, but we also need more time with patients. This is why the college has long been calling for 15-minute appointments, at least, to be standard in general practice – but offering longer appointments means offering fewer, and swift access to services is already strained.

'Not all patients value continuity of care - but many, particularly those with complex health needs, do and this study demonstrates that it’s essential continuity of care remains at the forefront of general practice.'

The study used outcome data for patients recorded in 2018 and looked at frequency of GP visits and morbidity in the three preceding years, with weighting for factors including age, sex, ethnicity and rurality.

Lead author and senior researcher Hogne Sandvik at the National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, said: 'It can be life-saving to be treated by a doctor who knows you. If you lose a general practitioner you've had for more than 15 years, your risk of needing acute admission to hospital or dying increases considerably the following year.’

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Follow Us:

Just published

External wall of GP surgery with wording 'medical centre'

‘Utterly toxic’: GPs speak out over abuse and physical attacks on practice teams

GPs have condemned a rise in verbal and physical attacks on practice staff - warning...

Artist's image of a spiked virus

Javid warns of 'substantial risk' from new COVID-19 variant

The highly mutated COVID-19 variant B.1.1.529 'may pose a significant risk to public...

Desk with lettering 'LMC conference'

LMCs reject 'outdated' GMS contract and demand move to item of service payments

LMCs have voted to scrap the 'outdated and inadequate' GMS contract and to replace...

GPs at an LMC conference waving green voting cards in the air

LMCs demand ringfence on enhanced services cash and clear GP representation in ICSs

LMCs have called for a ringfence on enhanced services funding, along with a guarantee...

Close up of hands typing on a computer

Practices should not be required to provide online consultations, say LMCs

Online consultations should no longer be a part of the GMS contract and targets for...

Sign outside BMA House

More than half of GP practices prepared to pull out of PCNs, BMA ballot shows

More than half of GP practices in England are prepared to opt out of the PCN DES...