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Continuity of care should be added as a new quality indicator, study suggests

by Beth Gault
8 July 2022

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A new quality indicator of ‘usual provider of care’ (UPC) should be considered to try and improve patient satisfaction in primary care services, a study has suggested.

The research, called Measuring continuity of care in general practice, looked at UPC scores to assess continuity of care across 126 practices in east London between 2017 and 2018 and compared them with the 2019 GP Patient survey response questions on GP continuity.

It found that there was a ‘strong correlation’ between those patients saying they were able to speak to their preferred GP and the UPC score for the practice over a two-year period.

The authors of the study said assessments by practices and health commissioners on continuity of care within practices is ‘rarely undertaken’, despite ‘well documented clinical benefits of longitudinal doctor-patient continuity’.

They added that regular use of UPC scores within primary care could have a positive effect on clinical outcomes and satisfaction for both patients and doctors.

They said: ‘There is increasing evidence that longitudinal continuity, used as a marker of relationship based clinical care, provides better clinical outcomes particularly for those who are older, and those with complex problems where patient preferences and clinical judgement may trump guideline-based care.’

The authors noted that this would go ‘against the grain’ of recent developments within primary care, including increasing specialisation, larger practices, emphasis on rapid access and the changing of professional working patterns.

However, they said it was good doctor-patient communication, rather than rapid access, that was the stronger driver of patient satisfaction.

They added that implementing a change would require leaders who ‘no longer take for granted’ the value of continuity of care and that GPs ‘must play a more active role in making it possible’.

‘We suggest that the UPC could be considered as a new quality indicator for practices, with regular assessment on a rolling basis,’ said the authors.

‘Providing resources and incentives to improve care in this way will require engagement from the emerging primary care networks and integrated care systems. Local initiatives to improve continuity, such as the development of micro-teams within larger practices, or changes to booking systems, need to be underpinned by reliable monitoring data.’

It comes after patient satisfaction with GP services has dropped by 30 percentage points since before the pandemic.