We are eight ordinary GPs in North East England — serving 13 000 patients. We contend that continuity of care is both achievable and necessary in 2023. We all work 3–4 days per week (providing 54 clinical sessions — plus five GP registrar sessions). We have our own personal lists, for both acute and chronic matters, and are all partners. Continuity of care is measured using the St Leonard’s Index of Continuity of Care (SLICC) tool.1 From August to October 2023, we averaged 81.9% (combined face-to-face and telephone), which is comparable with Norwegian levels.
Personal lists preserve the GP as a generalist, while creating the environment for relational care to flourish. As patients get ever more complex, knowledge of the patient’s history facilitates managing multimorbidity. Patients benefit too: no need to retell their story and trust develops after a few consultations. Collusion of anonymity is avoided. Lines of responsibility are clear and simple. This aids both practice staff and patients. For the doctor, a list is both professionally rewarding and provides a boundary for responsibility. Our 5-year national survey data2 show consistently excellent levels of patient satisfaction, access, and continuity — which is rare for a medium-sized practice. In addition, we have noted reduced hospital admissions,3 which is akin to the findings of Sandvik et al.4
We are not alone. An estimated 10% of English GP practices run personal lists — in different settings (urban/deprived/ rural) using differing models (clinical triage or traditional models) to suit their local needs. Several of these submitted evidence to the health select committee.5
For doctors and policymakers, forget uberisation — continuity using personal lists is the next logical step in renewing and revitalising general practice.5 It is easily achievable for most practices (with sufficient GPs to make it work). We feel we are a happier, more cohesive practice, with low staff turnover, due to having our own lists.
With proven patient benefits (morbidity reduction,4,6 better access,2 and greater satisfaction2), we should now all be asking — why isn’t my surgery running personal lists?
Notes
Competing interests
Luke D Sayers and the practice have collaborated with St Leonard’s, Exeter, to utilise the SLICC tool and share periodic SLICC data from November 2021–present.
- © British Journal of General Practice 2024
