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Independents' Day

Continuity we can all agree on

Put two GPs in a room and you get three opinions, or so the saying goes.

Put two GPs in a room and you get three opinions, or so the saying goes.

It's not always true though. GPs may disagree about everything from polyclinics to PMS, but when it comes to the core values of general practice, they tend to be overwhelmingly in agreement.

So it is in Pulse's survey of 500 GPs this week. Among the 300 or so GP partners who responded, a resounding 98% felt continuity of care was key to the profession – the sort of number that normally only crops up in rigged elections or assessments of QOF achievement.

But a series of changes to general practice – from the rise of part-time working to the shortage of partnerships and push for larger practices – are all conspiring to make continuity of care more difficult to offer.

Three-quarters of partners still felt they could offer continuity to patients, but that figure was far lower – at only 48% – for salaried doctors.

Given that the number of salaried posts has more than doubled since 2004, some profound changes appear to be in motion to the type of service GPs can deliver.

Salaried GPs more often work part-time, and know fewer of their patients, than partners.

But given salaried doctors are there to focus on patient care, rather than practice management, it must be a source of frustration to them and their employers that many feel unable to deliver a personal service.

Corrosive effect

Here is early evidence that the trend to replace partnerships with salaried posts is having a corrosive effect – and should add impetus to the BMA's efforts to address the problem.

But salaried doctors are around to stay and more needs to be done to help them achieve the continuity of care patients deserve.

Pulse's special report on the state of the profession looks at ways of offering continuity while working part-time or in super-surgeries.

Modern general practice can still offer a personal service, but it needs to work at it.


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