Patients are finding it much more difficult to see the same GP each time they book an appointment, researchers have found.
Only half of people are able to see their ‘preferred’ family doctor most of the time – down from two-thirds five years ago.
In the first study of its kind, the University of Leicester researchers analysed 6,243 surgeries from 2012 and 2017.
Over that five-year period, they found that ‘continuity of care’ – a measure of patients being able to see their preferred GP – had dropped by more than a quarter.
Lead author Professor Louis Levene said the trend was partly due to the rise of locum GPs in place of full-time doctors. Many GPs are choosing to work part-time – or as locums, doing shifts – to look after children or pursue other medical careers.
Patients are finding it much more difficult to see the same GP each time they book an appointment, researchers have found
In addition, increasing numbers of surgeries have merged to form ‘super practices’, with teams of doctors rotating between branch surgeries.
On top of this, longer waiting times mean patients are fortunate to get a prompt appointment – regardless of who they see.
GP surgeries across England are struggling to cope with the ageing population, migration and a recruitment crisis of doctors. In 2014, the Government promised to improve care by providing the over-75s with a named GP. This was extended to all patients two years later.
But the latest study found that patients’ ability to see the same GP had actually declined over that time, particularly for the elderly.
Professor Levene said: ‘This study shows that continuity of care has declined markedly and widely in England, despite Government changes to GP contracts requiring a named doctor. Higher levels of continuity are associated with patients more likely to take their prescribed medication and being less likely to need an emergency hospital admission.’
Only half of people are able to see their ‘preferred’ family doctor most of the time – down from two-thirds five years ago
Patients Association chief executive Rachel Power said patients with long-term conditions were having to ‘start from the beginning’ at each appointment. ‘Continuity in relationships with GPs and other professionals is one of the key elements in ensuring that care meets each person’s individual needs,’ she said. ‘All patients value their relationship with their own GP.
‘General practice is facing the perfect storm of workforce pressures and rising patient demand due to demographic change, so it is unsurprising that continuity in GP-patient relationships is suffering.’
Dr Richard Vautrey, chairman of the British Medical Association’s GP committee, said: ‘We cannot underestimate the importance and value of the long-term relationship with patients that a GP practice can provide, which benefits not only individual patients but also the wider healthcare system. Though GPs and staff at surgeries continue to work hard to provide a high level of service, these figures are an indication of the growing impact of unsustainable pressures on general practice.
‘Through no fault of GPs, the needs and expectations of patients are increasingly being unmet, largely due to the failure to address increasing staff shortages and insufficient funding.’
The study, published in the British Journal of General Practice, looked at satisfaction surveys from patients at 6,243 surgeries out of 7,600 in England.
A total of 47 per cent of patients in 2017 said they had a preferred GP, down from 52 per cent in 2012. But only 55.5 per cent were able to see this preferred GP most of the time, compared to 65 per cent five years previously. The researchers calculated that continuity of care had fallen by 27.5 per cent between 2012 and 2017.
Separate research last year found that elderly patients who saw the same family doctor were 12.5 per cent less likely to be urgently admitted to hospital. The academics said this was partly because patients trusted their GPs and were more likely to follow their advice and take their medication.
But many patients are struggling to get an appointment with any doctor because surgeries are under so much pressure.
Research commissioned by the Daily Mail last month found that half of patients cannot get an appointment within a week.
This is partly because surgeries are closing or merging, with the remaining practices having larger list sizes.
The Department of Health and Social Care said: ‘We want to ensure that everyone has access to GP services, including routine appointments at evenings and weekends – the latest statistics show more than half the population is currently benefiting from more flexible appointments.
‘To improve access to patients and availability of appointments, we’re investing an extra £2.4 billion a year into general practice by 2021 and will recruit an additional 5,000 doctors.’