Continuity counts A whole-practice approach to improving GP relational continuity

Repeated contact between a patient and a doctor gives them the opportunity for improved understanding of each other’s views and priorities, and is associated with a large number of health benefits including reduced hospital admissions and mortality. However, continuity of care is not often measured or managed.  

This project, led by St Leonard’s Research Practice, aimed to improve continuity of care in five GP practices in Devon through educating GPs, practice staff and patients about continuity of care, its benefits and measurement. Three city practices were involved, one seaside and one rural; with over 40,000 patients in total.  

More than 30 seminars were held separately for GPs, patients and staff in each practice to highlight research on continuity and provide analysis of each practice’s continuity.

GP continuity was measured using the St Leonard’s Index of Continuity of Care (SLICC) and the Own Patient Ratio (OPR); inclusive measures which include all GP consultations.

Despite pressures due to the COVID-19 pandemic, data show that four practices significantly increased continuity on the OPR for face-to-face consultations, and one practice also increased continuity on the face-to-face and telephone SLICC. The three practices that maintained personal lists had the highest levels of continuity. One practice didn’t make progress on continuity due to its priority changing to improving access.

When questioned after a consultation, 79 to 91 per cent of a sample of patients reported that they had a regular doctor.

The project team developed patient leaflets, a website and a continuity measurement toolkit, which other practices can use.

Contact information

For more information about this project, please contact Sir Denis Pereira Gray, Research Consultant, St Leonard's Research Practice.