Recommendation 21

HM Government · verbatim extract Accepted

Partially accept. The Department partially accepts this recommendation. As mandated in the GP contract, all patients must be assigned a named GP, who must lead in overseeing the care provided to a patient. Practices must endeavour to comply with all reasonable requests from a patient to see a particular GP. We agree that evidence on the benefits of continuity of care affirms its relevance for patient care and recognise the importance of continuity of care for many patients. The Fuller Stocktake sets out that identifying the patients who will benefit most from continuity of care should be determined through conversations with patients and clinical judgment. It also states that continuity of care has been directly linked to improved patient experiences and lower mortality for more complex patients. However, the stocktake highlights that some patients may, at different points in their lives, prioritise speed and convenience of access over seeing the same, named clinician. As such, we note that continuity of care needs to be pursued alongside a parallel focus on access, streamlining access to urgent and same-day care and advice. A toolkit by the Royal College of General Practitioners (RCGP) notes that while certain groups, such as those experiencing acute episodes of care, place a high value on continuity of care, there are others for whom this is not a priority. For the latter group, accessing primary care services quickly and conveniently is paramount, although, they note that this will change over time and at different points of life. The 2023/24 GP Contract promotes the use of the RCGP’s Continuity of Care toolkit via the Quality and Outcomes Framework Quality Improvement module on Managing Clinical Capacity, and within the Tackling Neighbourhood Health Inequalities Primary Care Network service specification. This is designed to further encourage continuity of care in general practice to help ensure more patients can benefit from it when appropriate. The RCGP has also published guidelines about how practices can achieve team-based continuity. For a patient with a range of needs it is sometimes more clinically appropriate for different groups of clinicians to combine their skills to offer continuity of care via multi-disciplinary teams, rather than a single named GP, this can also free up GPs’ time to see patients presenting with more complex issues. The RCGP has published guidelines about how practices can achieve team-based continuity. It is therefore important that we consider continuity of care in the context of multi-disciplinary team working, in which there is continuity and consistency in clinical management across the professionals involved in someone’s care. For instance, coordination, teamwork, good record systems and timely communication.