Evaluating the relational continuity of care of four GP practices, one of which uses personalised lists

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711713
Author(s):  
Riaan Swanepoel

BackgroundContinuity of care is a fading type of care because GPs are working more flexibly and at reduced working hours. The GP Contract gave a financial incentive to provide prompt GP appointments, but to the detriment of continuity of care. Increased patient demand for appointments has seemingly led to patients favouring ‘any’ appointment with a GP rather than ‘an appointment with the same GP’. Continuity of care in general practice is associated with greater patient satisfaction and is the preferred type of care for patients with chronic disease or psychological problems. In the Northeast of England there is a multi-partner GP practice that operates a true personalised list system. Other GP practices in the area do offer a degree of continuity of care, but this has not been measured.AimTo measure and compare the relational continuity of care index of four matched GP practices, one of which operates a personalised list.MethodA written protocol enabled the authors to extract comparable anonymised data from four GP practices over a year (January to December 2019). Two standardised indexes of continuity of care (UPC and SLICC) were calculated and compared.ResultsContinuity of care was consistently higher with personalised lists. UPC index results show that all GP practices provide surprisingly high continuity of care, albeit not with patients’ assigned GPs. Higher monthly UPC scores versus overall scores indicate patients are receiving continuity of care in relation to their condition.ConclusionContinuity of care is still observed in GP practices that do not have personalised lists.

2013 ◽  
Vol 5 (4) ◽  
pp. 322 ◽  
Author(s):  
Gill Scrymgeour ◽  
Rachel Forrest ◽  
Bob Marshall

INTRODUCTION: A Continuity of Cancer Care pilot project was established in two urban general practices, with the goal of improving cancer care and patient access to services. Practice nurses were engaged as coordinators to implement a model of care and patient navigation to offer continued and consistent care, and to assist the patient to navigate their cancer experience. AIM: The aim was to evaluate the effectiveness of the Continuity of Cancer Care pilot project. METHODS: Patients enrolled in the pilot project were invited to participate. Each participant completed a Patient Satisfaction Questionnaire and SF-12 Health Survey, and was then invited to take part in an interview. The evaluation framework utilised concepts of informational, management and relational continuity. RESULTS: The SF-12 subcategories of physical functioning, role physical, bodily pain and role emotional were lower than other results from cancer patients in the literature. The Patient Satisfaction Questionnaire and interviews indicated patients were satisfied with the relational continuity components of the project, but that gaps existed within the management and informational continuity aspects of care. DISCUSSION: Overall, the participants were satisfied with the Continuity of Cancer Care programme and valued the support, clarification and listening aspects of the programme. However, when evaluated in relation to a more comprehensive definition of continuity of care, there were distinct gaps. While the relational aspects of continuity of care were mostly achieved, the management and informational aspects appeared to be limited primarily to nurses acting to interpret hospital and general practitioner comments for patients. KEYWORDS: Cancer; continuity of patient care; general practice; nurses; nursing evaluation research; primary health care


BMJ ◽  
1992 ◽  
Vol 304 (6837) ◽  
pp. 1287-1290 ◽  
Author(s):  
P. Hjortdahl ◽  
E. Laerum

BJPsych Open ◽  
2016 ◽  
Vol 2 (5) ◽  
pp. 318-322 ◽  
Author(s):  
Rahil Sanatinia ◽  
Violet Cowan ◽  
Kirsten Barnicot ◽  
Krysia Zalewska ◽  
David Shiers ◽  
...  

BackgroundUsers of mental health service are concerned about changes in clinicians providing their care, but little is known about their impact.AimsTo examine associations between changes in staff, and patient satisfaction and quality of care.MethodA national cross-sectional survey of 3379 people aged 18 or over treated in secondary care for schizophrenia or schizoaffective disorder.ResultsNearly 41.9% reported at least one change in their key worker during the previous 12 months and 10.5% reported multiple changes. Those reporting multiple changes were less satisfied with their treatment and less likely to report having a care plan, knowing how to obtain help when in a crisis or to have had recommended physical health assessments.ConclusionsFrequent changes in staff providing care for people with psychosis are associated with poorer quality of care. Greater efforts need to be made to protect relational continuity of care for such patients.


2007 ◽  
Vol 12 (3) ◽  
pp. 132-137 ◽  
Author(s):  
David Turner ◽  
Carolyn Tarrant ◽  
Kate Windridge ◽  
Stirling Bryan ◽  
Mary Boulton ◽  
...  

Objectives: To estimate the relative importance to patients of continuity of care compared with other aspects of a primary care consultation. Methods: We carried out a discrete choice experiment in Leicestershire and London on a stratified random sample of 646 community dwelling adults taken from general practitioner (GP) registers, plus 20 interviews with Punjabi, Urdu and Gujarati speakers. The attributes examined were: the type of professional consulted, relational continuity, informational continuity and access. Results: Individuals' values changed according to their reason for making a primary care consultation. If consulting for minor familiar symptoms, individuals would be prepared to trade off one extra day's wait to see a GP rather than a nurse, 0.9 days for relational continuity, and 1.6 days for informational continuity. If consulting for a new condition they were uncertain about, they would be prepared to trade off an additional wait of 3.5 days to see a GP rather than a nurse, 2.4 days for relational continuity and 3.9 days for informational continuity. For a routine check-up, an individual would be prepared to trade off an additional wait of 3.5 days to see a GP rather than a nurse, 4.2 days for relational continuity and 7.8 days for informational continuity. Conclusions: Respondents stated their preference to wait longer to see a familar medical practitioner who was well informed about their case when they had a problem causing uncertainty or needed a routine check-up. They preferred quick access for likely minor 'low impact' symptoms. Appointment systems in general practice should be sufficiently flexible to meet these different preferences.


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