Observational studyThe British journal of general practice : the journal of the Royal College of General Practitioners2020
Changes in patient experience associated with growth and collaboration in general practice: observational study using data from the UK GP Patient Survey.
Observational study in The British journal of general practice : the journal of the Royal College of General Practitioners, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- What patients want from access to UK general practice: systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Pooled it
- Access or continuity: a zero sum game? A systematic review of the literature examining the relationship between access and continuity in primary healthcare.BMC primary care · 2025Pooled it
- Primary care micro-teams: an international systematic review of patient and healthcare professional perspectives.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Pooled it
- Public primary healthcare service network planning in Finland: a document analysis of principles, justifications, and future directions.Scandinavian journal of primary health care · 2026Article
- Continuity in a fragmented healthcare system: - organizational and individual determinants.Scandinavian journal of primary health care · 2026Article
- Continuity of care in UK primary care: a scoping review of measures, challenges, and future interventions.Primary health care research & development · 2026Article
- English general practice in a period of change: a mixed-methods study of staff and patient perspectives.BJGP open · 2026Article
- What do patients and clinicians think about continuity in general practice in England? a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Scale, Skill-Mix, and Access Implications of the Production of Appointments by Primary Care Practices in England.Health economics · 2026Article
- Experiences of access to general practice in England: qualitative study and implications for the NHS 10 year plan.BMJ (Clinical research ed.) · 2026Article
- Continuity of care for all? Associations between migration background and personal continuity among persons aged 50 and older in Dutch primary care: a registry-based observational study.Family practice · 2025Observational
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- Team climate, job satisfaction, burnout and practice performance: results of a national survey of staff in general practices in England.BMC primary care · 2025Article
- Patient experience and primary care teams: a cross-sectional survey of French elderly patients.BMJ open · 2025Article
- Did a national extended access scheme translate to improvements in patient experience to GP services in England? A retrospective observational study using patient-level data from the English GP patient survey.BMC health services research · 2025Observational
- A hole in the bucket? exploring England's retention rates of recently qualified GPs.Human resources for health · 2025Article
- Additional Roles Reimbursement Scheme uptake, patient satisfaction, and QOF achievement: an ecological study from 2020-2023.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
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- Article
- Practice list size, workforce composition and performance in English general practice: a latent profile analysis.BMC primary care · 2024Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFor the last few years, English general practices - which are, traditionally, small - have been encouraged to serve larger populations of registered patients by merging or collaborating with each other. Meanwhile, patient surveys have suggested that continuity of care and access to care are worsening.
aimTo explore whether increasing the size of the practice population and working collaboratively are linked to changes in continuity of care or access to care. DESIGN AND
settingThis observational study in English general practice used data on patient experience, practice size, and collaborative working. Data were drawn from the English GP Patient Survey, NHS Digital, and from a previous study.
methodThe main outcome measures were the proportions of patients at practice level reporting positive experiences of both access and relationship continuity of care in the GP Patient Survey. Changes in proportions between 2013 and 2018 among practices that had grown and those that had, roughly, stayed the same size were compared, as were patients' experiences, categorised by whether or not practices were working in close collaborations in 2018.
resultsPractices that had grown in population size had a greater fall in continuity of care (by 6.6%, 95% confidence interval = 4.3% to 8.9%), than practices that had roughly stayed the same size, after controlling for other factors. Differences in falls in access to care were smaller (4.3% difference for being able to get through easily on the telephone; 1.5% for being able to get an appointment; 0.9% in satisfaction with opening hours), but were statistically significant. Practices collaborating closely with others had marginally worse continuity of care than those not working in collaboration, and no differences in access.
conclusionLarger general practice size in England may be associated with slightly poorer continuity of care and may not improve patient access. Close collaborative working did not have any demonstrable effect on patient experience.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.