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Improving access and continuity in general practice

Practical and policy lessons

Authors: William Palmer, Nina Hemmings, Rebecca Rosen, Eilís Keeble, Sally Williams and Candace Imison

As the Improving Access to General Practice programme rolls out across England – with additional investment intended to deliver 100% coverage of the population by October 2018 – NHS England commissioned the Nuffield Trust to conduct a project to investigate the impact of improved access upon continuity of care.

This report summarises our key findings and provides a series of recommendations for commissioners and policy-makers (page 17). It sets out the evidence on continuity of care, its impact on clinical outcomes and wider health services, its importance to patients and GPs, and the relationship between improved access initiatives and continuity of care within general practice. The report aims to help providers, commissioners and policy-makers maximise the opportunities to improve continuity provided by the additional investment in primary care to support improved access. It examines how to achieve the optimal balance between these two dimensions of care when redesigning services for local populations.

We set out to address four key questions:

1 What is the evidence that continuity within general practice benefits patients, or is important to health professionals?

2 Which primary care patients are more likely to want continuity of care, and how likely are they to report receiving it?

3 How might policy initiatives to improve access affect continuity of care, and to what extent is there evidence of this?

4 What factors might best support continuity of care in the context of improved access?