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Blog

Harry Longman
Thursday, 19 July 2018 / Published in Comment

Improve continuity, die less often

Did you hear the wonderful piece on Inside Health yesterday as Mark Porter interviewed Sir Denis Pereira-Gray? Listen on iPlayer from 4:40 minutes.

Sir Denis has been a tireless campaigner for relational continuity and his new paper published in BMJ Open. is the first systematic study linking better continuity with reduced mortality.  Boom – the doctor knows the patient, they are likely to live longer.

But as he points out,  continuity is actually falling, by an astonishing 27.5% between 2012 and 2017 as measured in this Leicester paper.

This is not inevitable.

It is the consequence of policies, system design and operational practice.

Therefore reversing the decline is a choice.  The question is how?

Working with a huge range of GP practice structures and sizes, we have a very simple method.

  • GPs set up their availability
  • Patient chooses named GP
  • Reception assigns patient to GP.

The data is interesting – only 25% of patients name a GP and quite often reception will look up the usual GP and assign to them.  But most patients don’t mind and where it doesn’t matter, this gives enough flexibility to share the workload evenly.

It all happens within the normal flow of the demand led day, and crucially patients who feel their need is urgent are not faced with the dilemma of “You can see the duty doc today or that one you want in 3 weeks”

Now all of a sudden there’s a way to convert this into money.  There always was, since continuity improves efficiency as GPs sort things out once properly, and patients don’t create rework.

The new time limited way is thanks to the Health Foundation launching a programme to increase continuity in general practice.

All excellent stuff and I wish you well.

Harry Longman

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