Continuity of Care at St Martins

 St Martin's is improving our continuity of care is by introducing a Named GP to a group of patients that we feel will benefit the most.

What is Continuity of Care?

It is the extent to which a patient experiences an ongoing relationship with members of the clinical team. This can be the relationship between a patient and their GP. Many patients look to their GP as the 'keepers of their story' ie the doctor who knows them and their personal circumstances. Seeing the same GP each time (not lots of different ones) improves continuity of care.

Why is Continuity of Care important?

Seeing the same GP who knows your personal circumstances and previous history can make consultations more effective and satisfying. Although each new doctor can access your past medical notes on the computer, the relevant information can be difficult to access and time consuming to find. A doctor who already knows you can more easily work out your current problem in the context of your past history. This can lead to more accurate diagnoses, more effective treatments and avoid unnecessary referrals and investigations.

There is good evidence to show that continuity of care improves patient outcomes. A large study involving millions of people was published in the British Journal of GPs¹ and showed patients with the same regular GP for many years compared to those with a GP for less than a year were:

- 30% less likely to use ‘out of hours’ services

- 30% less likely to be admitted to hospital

- 25% less likely to die

Why is St Martins working on Continuity of Care?

It was a key area of improvement identified in feedback and complaints from our patients.

Continuity was once commonplace in General Practice where patients would often have their own 'family doctor' who they would see over many years. Various factors including bigger patient populations, larger practices and changes in GP workload have meant levels of continuity have been falling over the years. Patients are now likely to see multiple different GPs each time they visit. Unless practices actively do something to reverse the decline, levels of continuity are likely to continue to fall along with all its benefits.

This is why we have introduced Named GPs to a group of patients. 

What is a Named GP and what will they do?

This will be one of the GPs at the practice that will oversee your overall care. All routine appointments should be booked with your Named GP where at all possible. For urgent health problems that need a same day appointment, we will try to book with your Named GP but if they are not available you will see a different GP for that urgent problem. We would try to arrange any required follow up with your Named GP.

We will also aim to send all correspondence from other health professionals such as hospital letters to your Named GP. 

Who has a Named GP?

We have selected a cohort of patients who are likely to benefit from a Named GP the most. These are usually patients with more complex medical histories or needs. We have also included patients whom GPs felt would particularly benefit.  

Does everybody get a Named GP?

At present we are only introducing a Named GP to a small group of patients who have more complex medical needs. Introducing a Named GP to all the thousands of patients under St Martins care would be practically very difficult to implement and so for now we are focusing on the patients who are likely to benefit the most. 

Who is my Named GP?

We have shared the allocation of a Named GP evenly between the GP partners and salaried doctors to ensure workload is spread across the team. Some patients will already have a GP who they see regularly so we have tried to allocate this accordingly. Some patients may be allocated a GP they have not seen that many times before, however, this GP will get to know your history and the doctor-patient relationship will build as you see them over time.

We will write to you or send you a text message to let you know your allocated Named GP.

Can I change my Named GP?

Whilst it is within your rights to request a change in Named GP, we would request that you only do this if you have strong feelings regarding this. This is because we need to spread out the GPS fairly between patients to avoid differences in workload between GPs. We will give you chance to request this when we let you know your Named GP.

What are the next steps?

We kindly ask for your cooperation and help with this new system as it is designed to improve your own healthcare. For routine appointments, it might be that another GP is available sooner than your Named GP, however, we would strongly encourage you to wait and book in with your Named GP. This is because the benefits of continuity of care should far outweigh the benefit of a slightly shorter wait for an appointment.

References

1. https://bjgp.org/content/72/715/e84