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GPs may be neglecting continuity of care, academic warns

By Gareth Iacobucci

GPs may be wrongly prioritising access over continuity of care due to the 'adverse consequences' of linking patient survey results to pay, a leading primary care academic has warned

Professor Chris Salisbury, professor of primary care at the University of Bristol, and a GP in Bristol, warned that linking incentive payments to access may be causing GPs to neglect continuity of care, despite it being important to many patients.

In an editorial in the BMJ, advising other countries on ways to link pay to patient experience, Professor Salisbury, who has carried out extensive research into primary care access, said the current UK system ‘undermines confidence in the pay for performance scheme'.

‘The focus on access in the UK system is likely to encourage practices to prioritise this rather than encourage good continuity of care and good interpersonal care, which are equally or more important for many people,' he said.

Professor Salisbury also suggested that responses to this year's survey had been influenced by the demographic status of those responding, and called for survey scores to be adjusted to account for varying patient characteristics.

‘Consideration should be given to adjusting scores according to sociodemographic characteristics of practice populations,' he said.

He called on the Government to increase the sample size of the survey to give more accurate estimates of practice performance, and also suggested that waiting times could be measured more accurately using data from electronic appointment systems, and appointment availability could be assessed via ‘simulated patients or independent audit'.

This year's patient survey has been dogged by controversy, with GPs across the UK losing an estimated £35m in funding, and GP performance under QOF falling as a result.

Professor Chris Salisbury

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