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Patients don’t ‘trust’ they will see their own GP, NHS England lead claims



The lack of continuity in GP care is resulting in too many patients attending A&E inappropriately, because they don’t ‘trust’ they will be able to see their preferred GP if they attend the practice, NHS England’s head of GP development has claimed.

Dr Robert Varnam, who is also a GP in Manchester, told delegates at a King’s Fund urgent and emergency care conference in London today that continuity and access were ‘inextricably’ interlinked, and that patients were less likely to reconsult when they had had access in the first instance to a GP who knows them.

But the GPC said demand for continuity was not universal, and said GPs should focus on providing continuity for patients with chronic illnesses to prevent them becoming urgent care cases.

Dr Varnam told delegates: ‘Just having more and more of something isn’t going to meet your needs. And so we see people getting more access to care, but then they reconsult somewhere else in the system very soon after because their needs haven’t been met.

‘We need to talk about right access to the right care, and that does include improving continuity of care: people able to see the person who knows them. They’re inextricably linked, they together make up safe, effective clinical practice.

‘And we need more of that, we do need to improve access. There are too many people who pitch up to a part of the system they themselves suspect is not the right one. But it’s because they don’t have confidence that they can get access to the person who knows them best.’

GPC chair Dr Chaand Nagpaul told Pulse: ‘I think that may be the case for some patients, but again, we need to see some data. Look it up, you see these gut reaction feelings we have aren’t matched by the stats and evidence.

‘So we have to be a bit careful around drawing too many conclusions for that, and for patients in urgent need, i.e. they’re ill, they’ve got a cough, a cold, a respiratory infection, acute abdominal pain. I think at that moment in time they just want to see a GP, they’re not looking at continuity.

‘Where continuity is important is with patients with chronic diseases. They may not be urgent care patients but patients who could need urgent care if they’re not managed optimally. But that’s not time critical. So we do need to enable GPs to provide continuity for those patients.’