Seeing your preferred GP is getting more difficult

Continuity of care – the long-term professional relationship between a patient and a chosen GP - is not only at the core of general practice but is recognised as being associated with better recognition of certain health problems, better concordance with medication, better uptake of preventive services and more cost-effective use of healthcare resources.

A new research study by the Department of Health Science's Louis Levene and colleagues from the University of Leicester looked at 6243 primary care practices with more than one GP in England. It is published in the British Journal of General Practice.

The two main findings of this study are:

  • Continuity, defined in this study by patients' answers to two GP Patient Survey questions about being able to choose and to see a preferred GP, fell by over one quarter in England during the period 2012 to 2017.
  • This marked decline was widespread and variations between practices were not predicted by socio-economic deprivation or other population and organisational factors.

The contractual requirement for patients to have a named doctor has, so far, not altered this steady decline in continuity, which coincides with longer waiting times for GP appointments, suggesting that workload pressures are, once again, creating problems for the doctor-patient relationship.

How much decline is due to workload, part-time doctors, or other factors? More detailed work within practices is needed. The Royal College of General Practitioners has produced a continuity toolkit to help practices measure continuity and to try to improve it.