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Gold, incentives and meh

Contract threatens continuity of care

GPs believe the proposed new contract will lead to a damaging reduction in the continuity of care they can offer patients.

Early results from Pulse's survey of GP opinion on the issue have revealed that 88 per cent of GPs believe patients would lose their ability to consistently see the same doctor as a direct result of the contract.

Only one in five of the first 100 GPs to respond felt continuity of care was a luxury the NHS could no longer afford.

The findings come as a warning to the GPC about the outcome of the February ballot on the contract as two-thirds of GP respondents said continuity of care was a 'vital aspect' of UK general practice.

Of those who said the contract would worsen continuity, two-thirds said this was because it will fragment care into packages. More than half of those GPs also said the deal will favour speedy access over continuity.

GP registrar Dr Merlin Willcox said in his response that GPs needed continuous contact with the same patient to enable them to make an accurate diagnosis.

Dr Willcox, who practises in Buckingham, Buckingham-shire, said: 'If you don't know the patients you are looking after, issues can get overlooked and from the patients' point

of view it is important that they see someone they can trust.'

GPs overwhelmingly felt that continuity of care was highly valued by patients.

More than three-quarters of the GPs said they thought patients with non-urgent problems would prefer to wait to see their own GP even if they had to wait more than two days for an appointment.

Fewer than one in 10 of the respondents felt the contract would lead to better continuity of care.

Dr Iain Henderson, a GP in Leeds, said that practices had to utilise their resources

more effectively to ensure that they continued to provide continuity.

He said: 'I think that it is very much down to the practice to ensure smooth running of the changes that may affect continuity of care.'

More than four out of five GPs offer a telephone advice service to patients. In 40

per cent of cases the service

is provided by the patient's own GP.

Access to a GP within 48 hours for a non-emergency appointment was provided by 57 per cent of respondents.

It is a vital aspect of general practice 66%

It is a luxury GPs can no longer afford 20%

It is less important than providing speedy access and protecting GPs from excessive demand 14%

How important is continuity of care?

If you think the contract will lead to worse continuity of care, is this because:

It fragments care into packages 64%

It favours speedy access over continuity 56%

It favours bigger lists 33%

Practice nurses will take over more care 33%

Out-of-hours opt-out will fragment continuity 28%

No answer 13%

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