'Seeing your own GP becoming increasingly difficult'

Continuity of care in GP services has been linked to greater patient satisfaction
Continuity of care in GP services has been linked to greater patient satisfaction
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People are finding it harder to see their family doctor, a new study has found.

Despite "relationship continuity" with a GP leading to better health outcomes, patients are finding it increasingly difficult to see their own GP compared with five years ago, experts have said.

Continuity of care in GP services has been linked to greater patient satisfaction, better health outcomes and fewer hospital admissions.

Yet the decline in "relationship continuity of care" is "marked and widespread", according to a new study published in the British Journal of General Practice.

The authors noted: "Relationship continuity is generally valued both by clinicians and by patients, especially those who are older or who have complex or worrying health problems.

"The benefits of increased relationship continuity include a more holistic approach to care, better recognition of some health problems, better concordance with medication regimens, better uptake of preventive services, and more cost-effective use of healthcare resources, including reduced hospital admission rates."

Researchers from the University of Leicester set out to examine whether people who lived in more deprived parts of England were less likely to have an ongoing relationship with their GP, or "relationship continuity".

But they found that the decline in the doctor-patient bond included all socio-economic backgrounds.

Drawing on data from GP Patient Survey between 2011/12 and 2016/17, concerning 6,243 GP practices across England, the experts concluded that: "Relationship continuity of care declined by 27.5% over the period 2012-2017."

And "deprivation scores did not predict variations in the decline of relationship continuity at practice level".

The authors added: "Greater relationship continuity of care is one mechanism for delivering safe, efficient, and co-ordinated care to increasingly complex patients."

They called for more research to examine the factors behind the decline.

Health and Social Care Secretary Jeremy Hunt has previously pledged that elderly people over the age of 75 would have a named accountable GP to take lead responsibility for the co-ordination of all services.

Yet experts concluded: "The contractual return to a named doctor has, so far, not led to improved continuity."

They said the situation is "unlikely to improve continuity unless the causes of its decline are found and addressed".

Commenting on the study, Professor Kamila Hawthorne, vice chairwoman of the Royal College of GPs, said: "Continuity of care is at the heart of general practice and is highly valued by both patients and GPs alike.

"It's disappointing but understandable to read that, according to this paper, continuity of care is reducing, but GPs across the country are striving to provide continuity, even if not in the traditional sense.

"Some practices, for example, are using innovative approaches to continuity of care whereby patients might not always see the same GP, but they will see, and build relationships with, one of a small team who will all have access to their medical records.

"The RCGP has developed a toolkit for general practice teams to support them to deliver continuity of care against a backdrop of changing patient needs, and significant resource and workforce challenges.

"But, ultimately, we urgently need NHS England's GP Forward View - which promises an extra £2.4 billion a year for general practice and 5,000 more GPs by 2020 - delivered in full, so that we have the resources and workforce to provide the care our patients need and deserve, tailored to their specific needs."

A spokesman for the Department of Health and Social Care said: "We want to ensure that everyone has access to GP services, including routine appointments at evenings and weekends - the latest statistics show more than half the population is currently benefiting from more flexible appointments.

"To improve access to patients and availability of appointments we're investing an extra £2.4 billion a year into general practice by 2021 and will recruit an additional 5,000 doctors."