Relational continuity for general practice patients with new and changing symptoms Valentine Health Partnership

GPs regularly see patients who have consulted with multiple doctors for a cluster of symptoms, without any GP having overall responsibility for their care. This could potentially delay diagnosis and treatment, and result in inappropriate or duplicated use of other services. Some of these patients are healthy working age adults without long-term conditions or complex health problems.

This project investigated whether providing these patients with greater continuity of care would improve experience and outcomes.

Practice data was analysed to identify and ‘flag’ patients with increased GP consultations. GPs then reviewed the notes of flagged patients and ‘tagged’ those who could benefit from continuity, following guidance developed by the project team. There were 584 patients identified as potentially benefiting from continuity, and 75% were tagged. Systems were developed to allocate tagged patients to named GPs and their ‘micro-team’.

Results show that patients who received continuity of care for more than half of their appointments had lower use of A&E and urgent care; 93% of staff said they were more likely to promote continuity; and of those patients who received continuity and responded to a texted question, 70% said they found it easier to see their preferred GP. Patients who received more than 50% continuity with a named GP made less use of A&E and urgent care services.

The project focused on patients who were usually healthy and were experiencing new or changing symptoms. It demonstrated that while continuity may not be needed (or wanted) by all patients, the range of patients that could benefit from it is wider than the groups who are typically described as needing continuity – namely frail older people and those with multiple long-term conditions or mental health problems.

The results provide evidence for promoting continuity at both national policy level and within other GP practices.

Contact details

For more information about this project, please contact Rebecca Rosen, GP Partner, Valentine Health Partnership.