Patient Perceptions of Relational Continuity in England: Insights from Two Cross-Sectional Surveys

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Abstract

Background
Declining continuity of care in England could disproportionately affect some patient groups.

Aim
To examine patients’ perceptions of continuity of primary care, identify factors associated with continuity, and measure changes in continuity of care for different patient groups following Primary Care Network (PCN) implementations.

Design and setting
Patients from three groups (older adults with polypharmacy, patients with mild/moderate anxiety or depression, and working-age adults (18-45 years) attending 19 practices in five PCNs surveyed at two time points (November 2021—April 2022, November 2022—April 2023).

Method
Relational continuity was measured using the Nijmegen Continuity Questionnaire (NCQ) score. Differences between patient groups and two time points were tested using multiple linear regression.

Results
Survey response rates were 362/1547 (23%) and 350/1528 (23%). Adults with polypharmacy experienced significantly better continuity than adults with anxiety/depression and younger working age adults after adjusting for PCN, practice and population level characteristics. Those who always/sometimes saw their preferred GP experienced significantly better continuity than those who never did. PCNs with pre-existing inter-practice collaborations were not associated with differences in relational continuity. Mean continuity did not change over time (2.93 (SD=0.08) versus 2.82 (0.07); difference=0.11, P<0.28).

Conclusions
We found differences in experienced continuity of care between patient groups. Relational continuity depends on seeing a preferred GP, not a non-preferred GP or other healthcare professional. Better continuity was associated with larger practice networks.

Original languageEnglish
JournalBritish Journal of General Practice Open
Publication statusAccepted/In press - 18 Dec 2024

Keywords

  • General practitioner (GP)
  • health care professionals (HCPs)
  • primary care
  • continuity of care
  • Nijmegen continuity questionnaire (NCQ)
  • primary care network (PCN)

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