Elderly patients receive better treatment and require less care if they see the same doctor each visit, according to a major study.
According to research from the University of Cambridge, millions of GP appointments would be saved if surgeries offered better continuity of care, especially among those with more complex care needs.
The largest analysis ever carried out on the topic – involving more than 10 million appointments across almost 400 practices in England – found that it significantly improved patient care while reducing doctors’ workload.
This was particularly true when it came to older patients, those with chronic illnesses and mental health care, which increased the time between visits by almost a fifth (18 percent).
Experts from the University of Cambridge and business school INSEAD analyzed more than 10 million GP consultations across 381 practices in England over an 11-year period.
They estimate that adopting this method of practice could reduce consultations by 5 percent, the equivalent of 15 million appointments, based on an average of 300 million each year.
A decade ago, about half of all appointments were with a patient’s primary care doctor.
But increasing pressure from growing health needs and a growing elderly population have seen this figure gradually decline.
The researchers used anonymised data from the Clinical Practice Research Datalink, which consists of more than 10 million GP visits between January 2007 and December 2017, with patients having had at least three consultations in the last two years.
They found that seeing the same doctor helped build relationships and improve understanding of an individual’s health care needs.
Higher levels of continuity of care were associated with better long-term health outcomes, they conclude, and fewer appointments did not result in an increase in emergency admissions.
The benefits increased the older the patient, with greater gains observed in those over 86 years of age, according to findings published in the journal Management Science.
This suggests that surgeries could direct these appointments to their older patients, to maximize benefits.
Dr Harshita Kajaria-Montag, lead author of the study, currently based at Indiana University’s Kelley School of Business, said: “The benefits of continuity of care are obvious from the from the point of view of relationships.
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‘If you are a patient with complex health needs, you don’t want to have to explain your entire medical history at every appointment.
“If you have a primary care doctor who is familiar with your history, it’s a much more efficient use of time for both the doctor and the patient.”
The findings come amid accusations that the NHS is discriminating against elderly patients by using “barriers” to limit opportunities to see a GP face-to-face.
A recent survey of more than 1,200 people aged over 60 found that 76 per cent had experienced difficulties getting a face-to-face GP appointment for themselves or a family member.
Eight in ten reported being forced to accept a telephone consultation and 71 per cent reluctantly saw another member of practice staff, while 18 per cent went to A&E after failing to get an urgent appointment with the doctor header.
Silver Voices accused some practices of discriminating against seniors by rejecting walk-in bookings and telephone requests for repeat prescriptions.
Analysis of England GP patient survey data by the Nuffield Trust shows that when asked “how often do you see or speak to your preferred GP when you would like?”, there has been a decrease in continuity of care over time.
Between 2018 and 2023, the proportion of patients who “always or almost always” saw or spoke to their preferred GP decreased from 26 percent to 16 percent, while those who responded “never or almost never” increased from 10 to 16 percent. 19 percent.
Professor Stefan Scholtes, co-author of the study from Cambridge Judge Business School, said consulting the same doctor could have substantial benefits, equivalent to increasing the GP workforce by 5 per cent.
He said “doing it right the first time” will reduce future workload by “avoiding new visits,” adding: “Better health translates into lower demand for future consultations.” Prioritizing continuity of care is crucial to improving productivity.”
GP leaders said continuity of care was “highly valued by both GPs and patients”, but increasing patient lists mean the average GP is now responsible for 260 patients more than six years ago.
Dr Victoria Tzortziou-Brown, vice-president of the Royal College of GPs, said: “We already know it is beneficial for patients, particularly those with complex health needs, and we know it has benefits for the NHS, and it is encouraging to see that This study has found that it can also improve GP workload.
He added: ‘The average number of patients per fully qualified GP is now 2,294, meaning each GP is, on average, responsible for 260 more patients than six years ago.
«This is unsustainable and makes it practically impossible to guarantee access to the same GP for all patients. However, it would be important to prioritize continuity of care for those who need it most.”