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At the heart of general practice since 1960

US professor urges UK not to abandon continuity of care

By Gareth Iacobucci

A leading American healthcare academic has warned the UK not to make the same mistakes as the US in its healthcare reform by abandoning continuity of care.

Professor Gordon Moore, Professor in the Department of Population Medicine at Harvard Medical School, told delegates at the RCGP conference that the UK's primary care system was envied across the world.

But he said current changes to the primary care landscape, such as the surge in the number of salaried doctors, and the onset of Darzi centres, risked eroding that reputation and destroying continuity of care.

Professor Moore said: ‘Continuity, it seems to me, is diminishing within general practice in the NHS. Choices are made about off-hours coverage, use of nurses to deliver care in the practice, the larger size of practice groups, and Darzi polyclinics. All of these are decreasing the likelihood that a given patient with a specific problem will see their own GP.'

Professor Moore also warned delegates about the ‘corporatisation' of general practice, which could either manifest in terms of a private firm running general practice, or by an existing practice choosing to employ more salaried GPs.

‘Corporatisation is coming to your town, whether it appears as international healthcare insurer vying for the right to provide general practice, or when principals in a practice higher salaried or sessional associates.

‘In my experience in the states, I have found that salaried practitioners without a long-term stake in the practices do not typically show the same drive, excellence, commitment and accountability to their patients as those who own their own practice.'

His comments came after a poll of more than 10,000 doctors in several countries suggested GP services in the UK were better than other countries, including the United States.

US healthcare patients

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