Seeing the same GP ‘means fewer wasted trips to hospital’

Older patients are less likely to be readmitted to hospital if they routinely see the same GP, according to research by the Health Foundation charity.

The researchers looked at data from 200 GP practices in England, involving 230,500 patients between the ages of 62 and 82 who had visited the doctor at least two times between April 2011 and March 2013.

Their findings showed that patients who saw the same GP on between 40 and 70 per cent of visits had nine per cent fewer unnecessary hospital admissions. Those who saw the same GP more than 70 per cent of the time had 12 per cent fewer admissions. The average figure across England is 61 per cent.

The researchers speculate that this could be because patients are more likely to follow the advice of a GP they know well, and GPs who know patients well are better able to understand their health needs during a short appointment.

Writing in the British Medical Journal, they said: ‘The image of a single GP providing care to a patient throughout their life is a powerful one. However, there seems to have been a decline in continuity in recent years.’

Adam Steventon, of the Health Foundation, said: ‘Improving continuity of care is not just what patients and GPs want, it could also help to reduce pressure on hospitals.

‘However, general practices are under considerable pressure and people are finding it increasingly difficult to see their preferred GP.’

Instant analysis
It is pretty much common sense that continuity of care is extremely valuable for patients with complex medical needs that are often challenging to manage.

The study itself is reasonable considering it is an observational study, but the definition of what constitutes an ‘unnecessary’ admission (that is, one that could have been managed by a GP rather than at hospital) is somewhat questionable.

The benefit of hindsight is what often renders a hospital admission unnecessary. For example, a patient seen in general practice may get admitted to hospital with an ultimately simple diagnosis because same-day tests are needed to rule out something more serious. In retrospect, we can see that not admitting the patient wouldn’t have caused them any harm. But nonetheless at the time their admission may have been necessary.

A GP who knows a patient well will undoubtedly have a greater grasp of not only managing these conditions but the patient as a whole — their social needs, their wishes, their health beliefs, and their expectations.

With dwindling resources, increased patient numbers and demand and falling numbers of GPs, this is becoming harder and harder to achieve, so the question is not so much whether continuity of care is important, but how on earth we are going to try and make it better.
MB
Research score: 3/5