Implementing continuity of care in general practice was a key theme at this year’s RCGP annual conference, which took place on 29 June–1 July

Monkey Business gp patient

Continuity of care was a key theme of the Royal College of General Practitioners’ (RCGP) 2022 conference, which took place on 29 June–1 July in London.

The conference was hosted in conjunction with the World Organization of National Colleges, Academies, and Academic Associations of General Practitioners/Family Physicians (WONCA). There were over 2500 attendees from more than 80 countries, with expert talks from healthcare professionals from across the world.

Continuity of care

On 29 June 2022, Professor Martin Marshall, Chair of the RCGP and Professor of Healthcare Improvement at UCL, and Dr Anna Stavdal, the current WONCA President, gave an insightful and impassioned talk on continuity of care and how it should be properly implemented in the current structure of primary care.

Professor Marshall and Dr Stavdal stressed the benefits of continuity of care, including its association with lower mortality rates, higher job satisfaction, and lower risk of burnout. However, they conceded that there are many barriers to its successful implementation, including the new ‘micromanaging’ structure of primary care, the increase in part-time GPs, and the current focus on speed of access rather than the quality of doctor–patient relationship.

Professor Marshall and Dr Stavdal focused on the ways in which general practice can develop and evolve continuity of care:

  • making care explicit—in Dr Stavdal’s eyes, patients need to feel comfortable enough to disclose sensitive information. She gave an example: ‘It is not enough to tend to the wounds of an abused mother only for her to go back home to her abuser
  • building a relationship—Professor Marshall pointed out that GPs spend on average 9.8 minutes per consultation, work 11-hour days, and speak to approximately 40 patients each day. He stressed that GPs need to see, and spend more time with, fewer patients
  • evolving GP training—the speakers emphasised that GP trainees need to be reassured that it is possible to build relationships in a short period of time, even if the traditional method of longitudinal relationships remains the gold standard
  • utilising remote consulting—it was highlighted in the talk that the implications of remote consulting need to be better understood, as these consultations tend to be shorter and do not tend to foster as much rapport as face-to-face consultations
  • sharing the burden—more than half of the consultations in the UK are delivered by healthcare practitioners other than doctors, Dr Marshall noted, and they can also deliver continuity of care. 

Professor Marshall emphasised at the end of the talk that the burden GPs face needs to be shared with everyone in the practice to ensure the delivery of better care: ‘continuity of care is a defining feature of family practice, but doctors should not have that monopoly’.

His introductory speech for the conference had a similar focus: ‘high-quality general practice provides first-contact care, a comprehensive set of services, coordination between health and care services and, lastly, the principle that I’m going to talk about today: continuity of care.’

The state of primary care

In a recent survey of GPs and trainees conducted by the RCGP, 42% of respondents said that they were likely to leave the profession in the next 5 years. The same survey revealed that 68% of GPs and trainees do not think that they have enough time to properly assess their patients, with 65% saying that short appointments are compromising patient safety. Just 39% of respondents said that they can deliver the relationship-based care their patients need.

Guidelines in Practice has recently conducted a survey on the current state of primary care 1 year after primary care networks were introduced, the results of which will be published in the July issue.

A recent joint letter by the RCGP to the Health Secretary of England has asked the Government to do more to address pressures on GPs that are impacting patient care, including continuity of care. It has more than 4600 signatories.

Lead image: Monkey Business/
Image 1: Monkey Business/