ArticleAnnals of family medicine2024
Ongoing Decline in Continuity With GPs in English General Practices: A Longitudinal Study Across the COVID-19 Pandemic.
Article in Annals of family medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled 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
- Article
- Continuity of Care as Diagnostic Infrastructure.Journal of evaluation in clinical practice · 2026Article
- Association of General Practice Continuity With Hospital Admissions and Costs: A Retrospective Study.Annals of family medicine · 2026Article
- Factors influencing confidence and trust in health professionals: a cross-sectional study of English general practices.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Deprivation scores and NHS practice payment trends in England 2018-2019 to 2023-2024:a multivariable analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Continuity of care in UK primary care: a scoping review of measures, challenges, and future interventions.Primary health care research & development · 2026Article
- Continuity of Primary Care in Community Health Centers.Annals of family medicine · 2026Article
- Experiences of access to general practice in England: qualitative study and implications for the NHS 10 year plan.BMJ (Clinical research ed.) · 2026Article
- Patient perceptions of relational continuity in England: insights from two cross-sectional surveys.BJGP open · 2025Article
- Article
- New directions in policy in NHS GP contracts.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Strengthening general practice will help improve longevity and could reduce health inequalities.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Fuzzy-set qualitative comparative analysis of influencing factors on family doctor service performance during major public health emergencies.Frontiers in public health · 2025Article
- Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeRelationship continuity of care has declined across English primary health care, with cross-sectional and longitudinal variations between general practices predicted by population and service factors. We aimed to describe cross-sectional and longitudinal variations across the COVID-19 pandemic and determine whether practice factors predicted the variations.
methodsWe conducted a longitudinal, ecological study of English general practices during 2018-2022 with continuity data, excluding practices with fewer than 750 patients or National Health Service (NHS) payments exceeding £500 per patient. Variables were derived from published data. The continuity measure was the product of weighted responses to 2 General Practice Patient Survey questions. In a multilevel mixed-effects model, the fixed effects were 11 variables' interactions with time: baseline continuity, NHS region, deprivation, location, percentage White ethnicity, list size, general practitioner and nurse numbers, contract type, NHS payments per patient, and percentage of patients seen on the same day as booking. The random effects were practices.
resultsMain analyses were based on 6,010 practices (out of 7,190 active practices). During 2018-2022, mean continuity in these practices declined (from 29.3% to 19.0%) and the coefficient of variation across practices increased (from 48.1% to 63.6%). Both slopes were steepest between 2021 and 2022. Practices having more general practitioners and higher percentages of patients seen the same day had slower declines. Practices having higher baseline continuity, located in certain non-London regions, and having higher percentages of White patients had faster declines. The remaining variables were not predictors.
conclusionsVariables potentially associated with greater appointment availability predicted slower declines in continuity, with worsening declines and relative variability immediately after the COVID-19 lockdown, possibly reflecting surges in demand. To achieve better levels of continuity for those seeking it, practices can increase appointment availability within appointment systems that prioritize continuity.
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