A new study published by the British Journal of General Practice found that patients’ ability to see their preferred GP is greater in English practices that have expanded compared to those that have stayed about the same size has become.
At the same time, advanced English practices have not achieved better access to nursing or provided a better overall experience. The ability to see the same GP is valued by many patients, and previous studies have shown that it can lead to fewer hospital admissions and fewer deaths.
In recent years the UK government has encouraged expansion, mergers and closer collaboration between practices. This should enable them to deliver services in new ways, work more efficiently and extend their hours of operation. Most recently, Primary Care Networks were set up across England in 2019 – collaborative groups of practices for larger populations.
The study, conducted by the University of Kent, analyzed changes in patients’ reported ability to see a preferred GP, their access to care, and the overall patient experience over the past few years based on responses to the UK GP patient survey. This survey asks questions to several hundred thousand people every year.
In the 644 practices, which grew by more than 20% between 2013 and 2018, the proportion of patients who stated that they could see their preferred GP fell by 10% from 59% to 49%, while in the 5,602 practices, who remained about the same size (ie less than 20% change in the number of patients), the same proportion fell by 7% from 63% to 56%. The decline remained greater for practices that had expanded, although other characteristics of the practices were taken into account, such as: B. the age distribution of the registered patients, the rural environment and the extent of poverty.
The research was led by Professor Lindsay Forbes at the Center for Health Services Studies at the University of Kent along with Professor Stephen Peckham (Kent and the London School of Hygiene and Tropical Medicine (LSHTM)), Professor Matt Sutton (University of Manchester) and Professor Katherine Checkland ( Manchester) and Hannah Forbes (Manchester).
These scientists are all part of the Policy Research Unit in Commissioning and the Healthcare System (PRUComm), a collaboration between LSHTM and the Universities of Manchester and Kent funded by the National Institute for Health Research. PRUComm examines how the health and social care system and the commissioning of its services can be improved and provides evidence to the Ministry of Health and Social Care to inform about the evolution of the policy.
Professor Forbes said: “Greater general practice in England may well be associated with somewhat poorer continuity of care and may not improve patient access. This shows that bigger may not be better with English basic services. Better health outcomes for individuals and patient experiences for those with long-term illness must be prioritized. Continuity of care is an important characteristic of high quality primary care, and it is important that we maintain it for the benefit of patients. It is also important that we collect good data on the practice’s collaborative work and growth, and monitor the impact on the patient experience. ‘
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British Journal of General Practice (2020). DOI: 10.3399 / bjgp20X713429 Provided by the University of Kent
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