INTRODUCTION
Relational continuity in general practice is associated with positive outcomes for patients, doctors, and health systems, including several of the most important outcomes in medical care, including reduced admissions to hospitals and reduced mortality.1–4 In 2022, a key question became how to measure continuity of GP care. The Conference of Local Medical Committees (2022), the policymaking body for NHS GPs, passed a resolution that continuity should be included in a future NHS contract for GPs.5 The Select Committee on Health and Social Care (2022)6 reporting on The Future of General Practice recommended that GP continuity be improved by measuring it in all practices by 2024.
Continuous measurement is important in quality improvement programmes. Achieving improvements in continuity requires effective measurements. If all practices reported a standardised measure of continuity, this might identify practices needing continuity support, and identify high-performing practices providing good models.
Different measures exist in continuity research. The calculation methods, advantages, and disadvantages of these for research have been described.7–9 Alternative measures have been promulgated by practices or NHS organisations. The Select Committee6 proposed that continuity be measured and reported quarterly in all general practices, using the Usual Provider of Care (UPC)10 or the St Leonard’s Index of Continuity of Care (SLICC).11
For a continuity measurement method to be useful, it needs to be simple for practices to use, to be easily understood by GPs and managers, and to capture meaningful continuity, ideally within a reasonably short timescale. Plans are already being made to measure continuity in English general practices but there are important differences between the various methods.
We compare the two methods recommended by the Select Committee and also consider the Bice–Boxerman COC Index,12 which is often used in research, and the Own Patient …
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