Proportion of older people with a regular GP sees sharp decline in UK

The UK’s elderly patients are now far less likely to see the same GP regularly than they were 10 years ago, and also significantly less likely than in comparative countries.

In all, 72% of UK respondents to the Commonwealth Fund 2024 survey aged 65 and over said they had a regular doctor or GP, 20 percentage points lower than in 2014. 

The positive response rate to the same question in previous surveys was 92% (2014), 84% (2017), and 76% (2021), marking a steady decline over the years.

The latest figure puts the UK ahead of only Sweden in the response rate to this question, while France and Germany scored at 98%. 

The survey, in collaboration with the Health Foundation, included nearly 17,000 respondents from 10 countries.  

The Commonwealth Fund survey saw the UK score better than most countries for patients getting same- or next-day appointments, although there was still a decline in positive responses of nearly a third in the last decade (45% in 2024 compared to 60% in 2014). 

The ability to see the same primary care doctor is associated with lower mortality, lower avoidable emergency hospital admissions and higher patient satisfaction, the Health Foundation pointed out.

The think tank’s assistant director of policy Ruth Thorlby said: ‘Being able to see the same GP is a central pillar of continuity of care. There is a wealth of evidence linking greater continuity of care with better outcomes for patients and health systems, including lower mortality, reduced hospital admissions and greater productivity. This is particularly important for patients with long-term conditions, which increase as people age.

‘While this survey suggests a majority of older people report being able to see the same GP, the proportion has dropped faster over the past decade than in most comparable countries. Behind this trend is a decline in the number of fully-qualified GPs per capita in England since 2015. This has put more pressure on GPs and other practice staff, leading to an increase in GPs reducing their hours or leaving NHS general practice altogether.

‘The Government has promised to “bring back the family doctor” and while there have been welcome steps to boost overall GP numbers and allied healthcare professionals, restoring continuity of care for those patients who need it most will need policies that increase the number of GPs in regular NHS employment and action to retain existing GPs so that no more are lost.”

Dr Katie Bramall, BMA GP Committee England chair, told Pulse: ‘It’s well evidenced that continuity of care – seeing the same staff in the same place close to home – is good for patients and their health. 

‘But this continuity of care depends on properly resourcing general practice. When practices are funded and staffed, patients can see the same GP consistently.  

‘Years of underinvestment mean many surgeries cannot employ enough doctors, creating the absurd situation where patients struggle for appointments while some GPs struggle to find jobs.  

‘To restore continuity of care, we must invest in general practice and the GP workforce.’ 

Rebuild General Practice said downward trend identified in the survey would continue without ‘urgent action’ to retain GPs.  

A spokesperson for the campaign group told Pulse: ‘Continuity of care is vital for patient safety and trust – especially among older patients – but years of underfunding and a shrinking GP workforce mean it has become harder for patients to see the same doctor.  

‘Unless urgent action is taken to retain GPs and invest in general practice, continuity of care will continue to decline.’ 

While in opposition, then-shadow health secretary Wes Streeting identified continuity of care as an area of improvement, stating his intention to give financial incentives to GP practices to allow patients to see the same doctor. 

The 2025/26 GP contract included incentives for practices to identify patients who ‘would benefit most from continuity of care’ via amendments to the Capacity and Access Improvement (CAIP) payment. 

A DHSC spokesperson said: ‘Through the Plan for Change this government is getting the NHS back on its feet and bringing back the family doctor. 

‘We have provided the biggest boost to GP funding in years and already recruited over 2,000 more GPs. The revamped NHS App will provide patients with a doctor in their pockets, access to remote consultations, and will use AI to provide instant advice for patients who need non-urgent care, available 24/7. 

‘By bulldozing bureaucracy we’re freeing up GPs’ time and they’ve delivered 7 million more appointments in the past year. There is more to do, but a recent survey showed nearly three quarters described their GP as good – up 6.2% since July 2024 – and one fifth said their service had improved.’

Aside from gathering data from patients self-reporting, continuity of care can also be inferred from electronic health records using measures like the Usual Provider of Care (UPC) index – the proportion of consultations a patient had that were with their ‘usual’ GP. 

A 2023 Health Foundation study suggested continuity of care in the UK decreases in less affluent areas, with patients in the most deprived deprivation quintile having a lower UPC index than those in the least deprived.