Sustaining named GP continuity requires organisational change: comparative implementation analysis in Finland

Waltteri Tuompo; Janne Mäkelä; Markku Timonen; Juha Auvinen

doi:10.3399/BJGP.2026.0036

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GP continuity of care can be regained: lessons from Finland
Serge Engamba, Kate Sidaway-Lee, Philip Evans and Sir Denis Pereira Gray

Published on: 20 August 2026

Published on: (20 August 2026)
Page navigation anchor for GP continuity of care can be regained: lessons from Finland
GP continuity of care can be regained: lessons from Finland
Serge Engamba, Honorary Lecturer in General Practice, St Leonard's Research Practice, Exeter, UK
Other Contributors:
Kate Sidaway-Lee, Research Fellow, St Leonard's Research Practice, Exeter, UK

Philip Evans, Professor of Primary Care Research, St Leonard's Research Practice, Exeter, UK

Sir Denis Pereira Gray, Consultant and Emeritus Professor of General Practice, St Leonard's Research Practice, Exeter, UK
We welcome the research on GP continuity by Tuompo et al (2026) in Finland.¹ With Norway maintaining a high national level of GP continuity through personal lists, it is interesting to see a government-funded system in another country seeking to regain GP lists.

The initiative improved continuity in both centres, though much more in one than the other: in Tuira the St Leonard's Index of Continuity of Care (SLICC) — the proportion of consultations with the named GP — rose to 0.31, against 0.16 in Pudasjärvi, with the other measures used showing the same pattern. Notably, Tuira's Own Patient Ratio of 0.88 shows that its GPs were mostly seeing their own listed patients; that the SLICC nevertheless reached only 0.31 suggests, as the authors note, that GP availability was a major limiting factor.

This comparative analysis clarifies the conditions necessary for success. Naming the responsible GP is an essential first step: without clarity within the practice about which GP that is, GP continuity cannot develop. However, other conditions are also required, including committed partners, trained reception staff and supporting administration. England's named accountable GP requirement was introduced without them, and both national evaluations found that the named GP alone was not enough,^2,3 as we noted at the time.⁴

Practices with a long history of encouraging patients to see their named GP, where...
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We welcome the research on GP continuity by Tuompo et al (2026) in Finland.¹ With Norway maintaining a high national level of GP continuity through personal lists, it is interesting to see a government-funded system in another country seeking to regain GP lists.

The initiative improved continuity in both centres, though much more in one than the other: in Tuira the St Leonard's Index of Continuity of Care (SLICC) — the proportion of consultations with the named GP — rose to 0.31, against 0.16 in Pudasjärvi, with the other measures used showing the same pattern. Notably, Tuira's Own Patient Ratio of 0.88 shows that its GPs were mostly seeing their own listed patients; that the SLICC nevertheless reached only 0.31 suggests, as the authors note, that GP availability was a major limiting factor.

This comparative analysis clarifies the conditions necessary for success. Naming the responsible GP is an essential first step: without clarity within the practice about which GP that is, GP continuity cannot develop. However, other conditions are also required, including committed partners, trained reception staff and supporting administration. England's named accountable GP requirement was introduced without them, and both national evaluations found that the named GP alone was not enough,^2,3 as we noted at the time.⁴

Practices with a long history of encouraging patients to see their named GP, where the whole team works to provide continuity, can achieve considerably higher levels. We reported 51.7% GP continuity with every GP in the St Leonard's Practice working part time;⁵ our latest published figure is 57.1%,⁶ and in recent months combined face-to-face and telephone continuity has been above 70% (unpublished practice data). The Whitley Bay Health Centre in Northumberland, using personal lists, has reported 81.9%.⁷

Clarifying which GP a patient should see, whenever possible, is the key to continuity. This development in Finland is important because it shows that GP continuity, even after being lost, can be regained.

References

1. Tuompo W, Makela M, Timonen M, Auvinen J. Sustaining named GP continuity requires organisational change: comparative implementation analysis in Finland. Br J Gen Pract 2026; doi:10.3399/BJGP.2026.0036
2. Barker I, Lloyd T, Steventon A. Effect of a national requirement to introduce named accountable general practitioners for patients aged 75 or older in England: regression discontinuity analysis of general practice utilisation and continuity of care. BMJ Open 2016;6:e011422. doi:10.1136/bmjopen-2016-011422
3. Tammes P, Payne RA, Salisbury C, et al. The impact of a named GP scheme on continuity of care and emergency hospital admission: a cohort study among older patients in England, 2012-2016. BMJ Open 2019;9:e029103. doi:10.1136/bmjopen-2019-029103
4. Pereira Gray D, Sidaway-Lee K, Evans P, Harding A. Having a named doctor in general practice is not enough to improve continuity of care. BMJ 2019;367:l6106. doi:10.1136/bmj.l6106
5. Sidaway-Lee K, Pereira Gray D, Evans P. A method for measuring continuity of care in day-to-day general practice: a quantitative analysis of appointment data. Br J Gen Pract 2019;69(682):e356-e362. doi:10.3399/bjgp19X701813
6. Sidaway-Lee K, Pereira Gray D, Fearn-Smith J, Buick A, Engamba S, Khan N, Evans PH. Development of a novel GP continuity measurement for practices without personal lists. Br J Gen Pract 2026; doi:10.3399/BJGP.2025.0624 (online first)
7. Sayers LD, Richardson S, Colvin D, et al. Realistic not romantic - real-world continuity in action. Br J Gen Pract 2024;74(738):11-12. doi:10.3399/bjgp24X735909
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Competing Interests: None declared.