Being able to see a GP they know and trust
remains important to the majority of patients, according to a study
published in the British Journal of General Practice (BJGP).
One thousand four hundred and thirty seven
patients aged between 18-80 years from 22 practices and a walk-in
centre in West London and Leicestershire responded to a
questionnaire about their preferences and experiences of continuity
in primary care. They were asked about nine aspects of care with
respect to their most recent consultation:
Three on elements of interpersonal continuity
– choosing a particular person, choosing someone known and trusted,
and choosing someone who knows personally the patient and medical
condition
- One on being able to book an appointment in advance
- Four on the person consulted – type of professional (for
example choosing a nurse or a doctor), someone of the same sex,
someone of the same ethnic group or culture, someone who would take
time to listen
- One on informational continuity – someone with paper or
computer notes containing the full medical history of the
patient
The study Interpersonal continuity of
care: a cross-sectional survey of primary care patients’
preferences and their experiences found that interpersonal
continuity was important to between 63 and 75 per cent of patients,
particularly those with poor health consulting with routine
problems. The majority of patients also wanted to consult someone
perceived as taking time to listen and with information about their
clinical history. Specifically:
Seeing someone known and trusted was important
to 62.6 per cent of responders
- Seeing a particular person was important to 65.2 per cent of
responders
- Seeing someone who knows the patient and medical condition
personally was important to 75.3 per cent of responders
The study showed that the groups who were more
likely to fail to get what they wanted were people in work, being
non-white, and being socially isolated. People in work and people
who were not in work for any reason other than retirement had more
difficulty experiencing interpersonal continuity than people who
were retired, while non-white ethnic groups and people who were
socially isolated had difficulty negotiating other desired aspects
of care.
In its conclusion, the study highlighted a
need for practices to have flexible appointment systems to take
account of the needs of people in work, and those who have
difficulty in negotiating for what they want.
Study author Professor Richard Baker, of the
Department of Health Sciences at the University of Leicester, said:
“The study shows that patients place great value on having access
to a GP they have built up a relationship with.
“We need policies that support interpersonal
continuity, and appointment systems in practices that allow
patients to consult the person they know and trust. This is
especially important for people with poor health and those who have
difficulty in using health services.”
Professor Mayur Lakhani, Chair of the Royal
College of General Practitioners and a practising GP said: “This is
one of the most important studies to be published in recent years.
Patients tell me that their care is fragmented - one of the reasons
for an increasing general dissatisfaction with services in the NHS
might be that insufficient attention is paid to values like
continuity and coordination. This paper gives us a modern framework
for thinking about continuity and shows that services must be
designed with this is mind.”
Ends
For more information please contact
Lorna Fletcher, RCGP Press Office, 020 7344 3136 / lfletcher@rcgp.org.uk
NOTES TO EDITORS
- Interpersonal continuity of care: a cross-sectional survey
of primary care patients’ preferences and their experiences is
authored by Richard Baker, Kate Windridge and John Bankart of the
Department of Health Sciences, Leicester University; Mary Boulton
of the School of Health and Social Care, Oxford Brookes University;
and George K Freeman of the Department of Primary Care and Social
Medicine, Imperial College London