Continuity of GP care: using personal lists in general practice

INTRODUCTION

Continuity of GP care, defined as a patient seeing a GP repeatedly over time, was a core principle in general practice, but has fallen in recent years.¹ Recently, however, continuity has suddenly moved from the shadows of policymaking to centre stage through research showing a dozen beneficial outcomes associated with it.^2–5 Although most of the evidence is observational, recent evidence has found a dose–response relationship in general practice.² On the balance of probabilities, continuity of care is beneficial for patients. However, while the evidence for continuity has never been stronger, BJGP Editor, Euan Lawson, wrote ‘we are losing this battle’.⁶

National averages conceal large local variations, and attitudes to the continuity of GP care now vary greatly. On the one hand, there are the majority of general practices that usually use the pooled list system of practice organisation. These practices mostly devolve continuity to patients and accept that substantial continuity of GP care is now too difficult to provide for more than a minority of patients. On the other hand, there is a smaller group of general practices that believe continuity of GP care remains fundamental and which provide good continuity, usually through personal lists. We write from one of these in a practice that has used personal lists continuously for 48 years. The philosophy being that for GP continuity every patient counts.