Continuity of GP care reduces acute hospitalisations and deaths, study finds

Long-term continuity of GP care is ‘strongly associated’ with lower mortality and reduced need for acute hospitalisations and out-of-hours services, a study has found.

The research, published in the British Journal of General Practice (5 October), found that when someone has been treated by the same GP for more than 15 years, the probability of these occurrences decreases by 25-30%.

The nationwide study looked at patients in Norway, where everyone has been listed with a regular GP of their own choice since 2001.

The study used high-quality national registries, which hold data on all patients’ contact with their GP, as well as out-of-hours services, specialists, and hospitalisations.

By linking these registries with data from Statistics Norway, the Norwegian statistics bureau, the researches showed that the length of the GP-patient relationship was linked to less use of out-of-hours services, acute hospitalisations and mortality in a dose-dependent way.

Frequency of visits to a GP and morbidity were recorded between 2015 and 2017.

This was used alongside outcome data, including the use of out-of-hours services, acute hospitalisations, and death, from 2018.

‘It can be life-saving to be treated by a doctor who knows you. If you lose a general practitioner you’ve had for more than 15 years, your risk of needing acute admission to hospital or dying increases considerably the following year,’ said Hogne Sandvik, lead author and senior researcher at the National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen.

In response to the study, RCGP chair Professor Martin Marshall said: ‘Continuity of care is highly valued by patients and GPs and our teams alike. It is what allows us to build relationships with our patients, often over time, and this study builds the strong evidence base of its benefits for patients and the NHS.

However, he said delivering continuity of care is becoming ‘increasingly difficult’ for GPs due to ‘intense workload and workforce pressures’, as well as ‘the need to prioritise access to GP services’.

He said: ‘However, GP teams strive to deliver continuity of care in innovative ways, such as working to build trusting relationships between different members of the practice team, not just the GP.

‘General practice urgently needs more GPs and more members of the practice team, but we also need more time with patients, so that we can build the strong and trusting relationships with patients that both patients and GP team members value.’

Professor Marshall went on to reiterate the RCGP’s longstanding call for a move to 15-minute appointments to become standard in UK general practice. But he acknowledged that offering longer appointments ‘means offering fewer’, and comes as ‘swift access to services is already strained’.

Last year, a UK study concluded that GP practices that have grown in size over the last few years have been less able to accommodate patients in seeing their preferred GP.