Continuity of care, as defined by care given continuously by one doctor, is one of the most oft talked about modalities of care provided by GPs; it’s the one we feel that’s under threat, the one we’re trying to defend, and the one the government has picked up on to protect and promote. It enables us to build therapeutic relationships, and many patients and GPs value it. Indeed, 50% of our consultations are for chronic conditions, where relationship continuity clearly plays a significant role.
But is it always a good thing? And is it even possible these days, given the changing shape of the GP workforce, organisational change in the health service, the increasing complexity of the work carried out in primary care and wider social changes amongst our patients? Relationship continuity isn’t necessarily all good. Patients can be taken up diagnostic and management cul-de-sacs, only to be rescued by a different clinician who was able to bring along a fresh perspective. Continuity can bring complacency, and assumptions – mistaken or stereotypical – that are adopted earlier on in the relationship can snowball.
General practice is nowadays practised differently to the traditional model that we and our patients were brought up with, the model powered by a continuous relationship with a family doctor available 24 hours a day. Your average GP is no longer a full time partner with ample time to get to know their patients intimately.