New 10-minute tool lets GP practices check their continuity-of-care score

Researchers have developed a new 10-minute benchmarking tool with which GP practices can monitor how well they perform on continuity of care.

The Bristol Continuity of Care Calculator, developed by researchers at the University of Bristol, aims to create benchmarks for practices to view to see how their continuity scores compare with others, and how scores vary across practices with different characteristics. 

The tool links to clinical records systems to measure care provided including face-to-face, telephone, and video consultations and home visits with a GP, over the previous two years. It then uses four metrics to create the overall benchmarking score.

The current version is compatible with EMIS and a new version compatible with SystmOne will be released ‘in the coming weeks’, the university’s Centre for Academic Primary Care (CAPC) said.

The four metrics included are: 

• Usual Provider of Care (UPC): the proportion of consultations a patient has in a period that were with their usual GP (ie the GP they see most often); 

• Bice-Boxerman Continuity of Care (COC): this index accounts for the number of other GPs the patient has contact with. For instance, if a patient saw just one other GP, three times (in addition to their usual GP), they would score higher than if they saw three others, once each; 

• St Leonard’s Index of Continuity of Care (SLICC): a measure of how often doctors see patients on their personal lists. Unlike the UPC and COC, SLICC is calculated for each doctor rather than each patient; 

• Modified SLICC: the proportion of consultations a patient has had with the GP they see most often. 

Professor Chris Salisbury, professor of primary healthcare at the University of Bristol, who developed the tool, said: ‘This is a simple tool that takes less than 10 minutes to run and provides a range of useful measures of continuity which are suitable for different types of practices, including those that have personal lists and those which provide continuity within teams. The tool can be used on a regular basis to monitor improvements over time.’

Professor Mark Rickenbach, GP and the RCGP’s clinical policy representative for continuity of care, said despite the ‘groundswell’ of support for improving continuity in recent years, it has actually been ‘declining’.

‘For years the missing key has been an easy way to measure continuity of care. Now, at last, we have one – a calculator that can link in with clinical records systems and use the common descriptors of continuity of care, which then feeds back to individual GPs and GP practices on how well they are doing. 

‘I am looking forward to hearing how useful other GPs find it, whether and how continuity of care increases, and how it positively impacts on – indeed saves – people’s lives.’ 

The 2025/26 GP contract included changes to the £87m Capacity and Access Improvement (CAIP) payment with a financial incentive for practices to identify patients ‘that would benefit most’ from continuity.

One of the payment’s domains (worth £29.2m) is for PCNs ‘to risk stratify their patients in accordance with need – including to identify those that would benefit most from continuity of care.’

Dr Luke Sayers, a GP partner at Whitley Bay Health Centre and project lead for continuity of care at North East and North Cumbria ICB, said the tool allows practices to ‘get a full picture of their baseline continuity’.  

Earlier this year, Pulse’s major white paper survey on GP access found that GPs overwhelmingly saw continuity of care as overwhelmingly their top priority – ranking it above routine waiting times, access to on-the-day appointments, time spent waiting on the phone, and consultation type (i.e. face to face or remote).  

Previous research of data from more than 200 practices has found GP continuity of care could reduce workloads in practices and A&E, potentially freeing up appointments.

The study found that patients who saw the same GP regularly had a longer time before their next consultation (an average of 61 days, compared with 56 for any other GP), meaning fewer consultations were needed in the practice.