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Independents' Day

Seeing different GPs makes patients ‘twice as likely’ to be admitted to hospital

Patients who see different GPs from visit to visit are more than twice as likely to be admitted to hospital, a study has found.

The study published in Annals of Family Medicine, found that older patients who do not see the same GP are at higher risk of emergency hospital admissions than those who saw the same or a small number of GPs.

Researchers looked at data from 10,000 records of patients aged 65 years and older, 297 practices in England between April 2010 and March 2014.

This data was cross-referenced with hospital records to measure continuity of care and the risk of emergency admissions.

The researchers suggested that plans to enhance continuity of care could reduce hospital admissions as trust in England face ‘sustained pressure with increasing emergency attendances’. 

This comes as Pulse reported that some trusts are facing ‘unprecedented demand’ this winter with three declaring black alerts early in the season due to high demand at A&E.

Dr Peter Tammes, senior research associate at the University of Bristol’s Centre for Academic Primary Care and lead author of the study, said: ‘Discontinuity of care reduces the opportunity for building trust and mutual responsibility between doctors and patients, which might underlie the increased risk of emergency hospital admission.’ 

He added however that more research is needed to more clearly understand the link between continuity of care and hospital admissions.

He said: ‘It would also be helpful to evaluate new schemes to improve continuity of care, such as the introduction in 2014 of a named GP for elderly patients - especially as the merging of practices into ‘super-practices’ is expected to lead to an overall decrease in continuity of care.’

The ‘named GP’ policy was introduced as part of changes to the GP contract in April 2014, requiring GPs to assign patients aged 75 and over a specific GP to be responsible for their care.

However, a study into 200 practices in England last year found that assigning elderly patients a ‘named GP’ did not have any effect on their continuity of care, with GPs at the time declaring it an ‘evidence based policy failure’.

Meanwhile, recent research has also found that patients are less satisfied in large practices where there is less continuity of care, adding that patients ‘highly valued their continuous, ongoing relationship with their own practice, their own doctor and the wider practice team’.

Readers' comments (13)

  • well spotted genius. We have a steady stream of academic studies confirming what we all know. At least it adds evidence to what is obvious to those at the coal face. Super practices will have to have a "continuity lead" and a "continuity protocol" whilst offering no continuity at all.

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  • So large primary care practices are going to lead to vastly increased costs in secondary care due to more acute admissions. Jeremy Hunt, the Treasury and DoH are going to love it..

    Ha ha...

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  • So are they going to make GP principle posts more attractive ?

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  • Quelle suprise

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  • Sometimes seeing a fresh face is beneficial though. The number of serious diagnoses including cancer that I've picked up from never seeing the patient before is shocking, when you look back the symptoms were all there but never acted on.

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  • We DON"T ADMIT ANYONE. We refer when we feel someone needs expert input from secondary care, they admit and then investigate for the next 2 weeks before sending the patient home again unfit for discharge.
    If a second pair of eyes feels someone needs that extra input then that is surely positive as they obviously needed to be kept in hospital.

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  • Vinci Ho

    The problem all the time is trying to value the telos and ethos of general practice in NHS through the eyes of economists. Technocrats only wants to feed their obsession of statistics with more and more figures .
    In their eyes ,continuity of care is an abstract ideology and cannot be measured . In fact , it is insulting to quantify a virtue and moral value by measurements. To me, the magic of continuity of care reminds me of the ‘ridiculous’ experiment of Erwin Schrödinger and his cat(Schrödinger's cat) : the meaning of quantum physics will be lost if one starts to do objective measurements.
    Problem we have is the so called ‘reality’ created by the government(s) had made , at least , some of us capitulate. Working by scale in a much larger practices is inevitably the new social norm , all of us (old and young) must accept this ‘new’ telos . After all , we are only toy soldiers manipulated by people higher in the hierarchy.
    Obviously, if survival is victory, there is nothing called right or wrong in here. But if one looks deep down in one’s conscience, is this oath we really swore serve in the first place ?

    ......Made weak by time and fate, but strong in will
    To strive, to seek, to find, and not to yield.

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  • David Banner

    It was this government that wanted it both ways, with super-sized practices on the one hand, and Named GPs on the other. With part-time GPs, full surgeries, "book on the day" only (etc), this Personalised Service throwback to an imagined 1950s Dr Kildare stylee vote-grabber was always nothing more than a conceited fantasy cynically designed to placate bewildered punters. The perfect example of Named GP would be a single handed practice, and we all know what Hunt has done to kill THEM off..........such a hypocrite.

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  • David Banner is right! they want their cake and to eat it too. nice try though.

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  • And there is always continuity in secondary care? I don't think so.

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