Improving continuity: THE clinical challenge

Continuity of care is a core feature of general practice; it creates multiple benefits for patients, doctors and society. Continuity increases trust, patient satisfaction, disclosure of information, take-up of preventive care, adherence to advice, reduction in socio-economic disadvantage, and reduces deaths. However, the level of continuity is reducing in general practice. About 15 consultations are needed with a patient for a GP to acquire enough ‘accumulated knowledge’ to develop a sense of continuing responsibility. This fosters GP sensitivity and mutual understanding, which enable GPs to provide ‘higher-level’ quality of care. The RCGP curriculum states two high-level aims: that GPs need to ‘enhance continuity of care’ and ‘build long-term relationships with patients’. This article analyses these aims by setting them in the context of international research on continuity of care.