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Hunt’s flagship named GP policy ‘had no impact on continuity of care’

Assigning elderly patients a ‘named GP’ did not have any effect on the continuity of care they received, a study has revealed.

The Department of Health said it was too soon to write off the policy, which was introduced by Health Secretary Jeremy Hunt to ‘restore the personal link’ between patients and their GP and has since been extended to all patients.

But one leading GP said the study showed there was no evidence to support the approach and that it should be scrapped.

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

Researchers at The Health Foundation looked at 200 practices in England, and found that within three months of the new contract starting, almost 80% people aged 75-85 – around 3.6 million patients – had been assigned a named accountable GP by their practice – up from 4% at the beginning of April 2014.

However, they found no difference in continuity of care these patients received over the next nine months – as measured by a ‘usual provider of care’ index, essentially a measure of how often a patient saw the same GP – when compared with younger patients receiving ‘usual care’.

They also found no change in the number of GP contacts, diagnostic tests or referrals per person after the policy was introduced.

The researchers concluded: ‘The introduction of named accountable GPs in England did not improve longitudinal continuity of care over nine months. Consequently, no changes were detected in numbers of general practice visits, referrals to specialist care and diagnostic tests.

‘Continuity of care is valued by patients and may also be associated with better patient outcomes, so efforts to improve this dimension of quality seem warranted. However, initiatives may be more effective if they more comprehensively address the context in which general practice operates and include support to change workflows.’

Dr Paul Cundy, GPC representative for the south of England, said: ‘This was a political non evidence based policy. It is now an evidence based policy failure.’

Dr Cundy added: ‘In an ordinary world it would be dumped, but Mr Hunt has an evidenced record of ignoring the evidence so I’m not holding my breath.’

A Department of Health spokesperson said: ‘This study only looks at the outcomes for the first nine months of the initiative, giving limited time for the benefits of a named and accountable GP to be realised.

‘We know that patients value continuity of care. That’s why from April 2015 all patients – not just those aged 75 and over – have had the right to a named GP.’

BMJ Open 2016; available online 16 September


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