GP practices across England were required to assign a specific, named GP responsible for the care of each patient aged over 75 on their list from 1 April 2014. From 1 April 2015, the scheme was expanded to all patients.
The measure, brought in under changes to the GP contract after negotiations between NHS Employers and the BMA's GP committee, aimed to improve care of elderly patients and keep them out of hospital.
But a study by researchers at the University of Bristol’s Centre for Academic Primary Care (CAPC), funded by the National Institute for Health Research, found that the mechanism did not increase patients' chances of seeing the same GP regularly or bring down risk of emergency hospital admissions.
Continuity of care
Instead, continuity of care fell and emergency admissions rose following the introduction of the named GP scheme, the research published in BMJ Open found.
The researchers looked at hospital and primary care data for more than 19,000 patients registered at 139 English GP practices and compared results for those aged 75-84 with those aged under 75. They found that continuity of care fell at a similar rate in both age groups after the scheme was introduced.
Emergency hospital admissions increased in both age groups, but rose faster for patients aged over 75.
Lead author Dr Peter Tammes, a CAPC senior research associate, said: 'The named GP scheme appears not to have delivered hoped-for results in terms of improved continuity of care and reduced emergency hospital admissions for older patients. This suggests that the policy of allocating a named GP is not, in itself, effective and more sophisticated interventions are needed.
Choice of GP
'It also raises questions about how the scheme was implemented – whether, for example, it would have made a difference if patients had been given the option to express a preference for who their named GP should be and how well they understood what having a named GP was for.'
The study found that 'the decrease in continuity of care was similar for those aged between 65 to 74 and for those aged 75 and older'. The researchers speculated that this was 'possibly because most patients were already listed at a GP list and introducing a named GP policy for older patients might not have changed their situation of being allocated to a GP much'.
The researchers added: 'We were also able to determine that continuity of care of patients in a practice providing on average low continuity of care dropped less compared with patients in practices providing on average high continuity of care.'