FOR HEALTH PROFESSIONALS
"ISN'T CONTINUITY A BIT OUTDATED?"
The days of single-handed GPs providing 24 hour care for their patients have gone. However, the benefits of knowing your patients still apply in modern general practice. In addition to the benefits highlighted it may save time. For example when checking test results as you don't have to check records as much. Or it may be possible to deal with a patient you know well through a telephone call rather than seeing them face-to-face. Many GPs still see providing continuity as an important part of their job.
"CAN WE PROVIDE CONTINUITY WITH PART TIME GPS"
Yes. Many practices provide continuity of care through personal lists despite GPs working part time. In one practice with seven part-time GPs, plus registrars, over half of all GP face-to-face appointments were with the patients' own GP.
"CAN WE DO CONTINUITY WITH A POOLED LIST?"
Not really. Data shows that attempting to do continuity without defining which patients each doctor has responsibility for doesn't really work. Also, patients can fall through the cracks if it is not clear which doctor is responsible for them.
"ISN'T THE EVIDENCE ALL OBSERVATIONAL?"
There has been one small randomised controlled trial of continuity which showed it improved outcomes. Most of the evidence is observational. However, there are dozens of studies showing the same association in different systems with different measurement methods. More recent studies use state-of-the-art statistical methods to reduce confounding. This makes it very likely that improving continuity will improve patient outcomes.
FOR PATIENTS
“I’M YOUNG AND USUALLY HEALTHY- DO I NEED CONTINUITY OF CARE?”
Younger, healthier people who rarely visit their doctor are less likely to experience the benefits of continuity. However, if a doctor gets to know you while you are young and healthy this may be useful later if you develop and on-going health problem.
“SURELY THE PRACTICE RECORDS HAVE ALL MY DETAILS ANYWAY?”
Although doctors do their best to write the important facts, it isn’t possible to include the whole of a consultation in the notes. Some things such as how a patient normally looks or talks, can’t be adequately recorded but doctors may remember if they see the patient again.
“SHOULDN’T I SEE ANY DOCTOR RATHER THAN WAIT FOR MY OWN DOCTOR?”
Sometimes, if you need urgent care and your doctor is not available. However, if possible try to see your own doctor as they will know you better and be able to provide better care.
“WHY IS THE NHS NOT MAKING CONTINUITY A PRIORITY?”
Current policies favour access over continuity, partially because this is what patients have asked for. However the evidence for benefits of good continuity is stronger than for improved access.