Continuity of care versus speed of access

Phil Johnson

General practice is facing a period of uncertainty, with the Government seemingly intent on using its forthcoming White Paper to shake up the core elements of a system that has served the NHS so well over generations. Whatever the outcome of ministers' high-profile ‘listening exercise’, it is already clear that increasing fragmentation of general practice will be an inevitable consequence of the Government's determination to give private providers a central role in primary care and to expand massively the network of NHS walk-in centres and commuter clinics.

Against this background, Mike Fitzpatrick's comments1 on the trade-off between continuity of care and speed of access to a GP are a welcome contribution to the debate.

Pulse has just published the results of its patient survey, conducted in partnership with Newcastle and North Tyneside local medical committee.2 Questionnaires were completed by 9812 patients attending for consultations at general practices throughout the UK during May and June 2005.

The results show emphatically that patients are more concerned with being able to see a GP they know and trust than with getting a quick appointment. Just 7% of patients said that if they needed to see a doctor they would prefer to have an immediate appointment at a walk-in clinic — compared with 79% who said they would rather wait up to 48 hours to see a GP at their own practice. Some 89% said having continuity of care from their GP was important to them and 90% said it was important for the GP treating them to know their family history.

Moreover, 64% of patients said they could get an urgent appointment with their GP within 6 hours and a further 12% by the following day. Some 76% said it was usually possible to get a routine appointment with the GP of their choice ‘within a reasonable time’.

The Government's obsessive pursuit of its so-called ‘patient choice’ agenda is missing the point entirely. GPs are delivering continuity of care alongside the fastest access that is feasible in an under-doctored NHS.

No doubt ministers are right when they claim that patients want faster access to primary care. But what they have failed to recognise is that, above all else, patients want continuity of care from a GP they know and trust.