Elderly patients receive better treatment and require less care if they see the same doctor each visit, a major study found.
Millions of GP appointments would be saved if surgeries offered better continuity of care, particularly among those with more complex care needs, according to research by Cambridge University.
The largest ever analysis on the subject – involving more than 10 million appointments at almost 400 practices in England – found it significantly improved care for patients, while also cutting the workload of doctors.
This was particularly true when it came to older patients, those with chronic conditions as well as mental healthcare – increasing time between visits by almost a fifth (18 per cent).
Experts at t the University of Cambridge and INSEAD business school analysed more than 10 million GP consultations in 381 practices in England over a period of 11 year
They estimate adopting this method of practice could slash consultations by 5 per cent – the equivalent of 15 million appointments, based on the average 300 million each year.
Around half of all appointments were with a patient’s regular doctor a decade ago.
But increased strain from growing health needs and a rising older population has seen this number gradually fall.
Researchers used anonymised data from the Clinical Practice Research Datalink, consisting of more than 10 million GP visits between January 2007 and December 2017, with patients who had at least three consultations over the past two years.
They found seeing the same clinician helped build relationships, improving understanding of an individual’s healthcare needs.
Higher levels of continuity of care were associated with improved long-term health outcomes, they conclude, with fewer appointments not resulting in increased emergency admissions.
Benefits increased the older the patient was, with the highest gains seen in those aged over 86, according to findings published in the journal Management Science.
This suggests surgeries could target these appointments to their older patient, to maximise benefits.
Dr Harshita Kajaria-Montag, lead author of the study, who is now based at the Kelley School of Business at Indiana University in the US, said: ‘The benefits of continuity of care are obvious from a relationship point of view.
‘If you’re a patient with complex health needs, you don’t want to have to explain your whole health history at every appointment.
‘If you have a regular doctor who’s familiar with your history, it’s a far more efficient use of time, for doctor and patient.’
The findings come amid allegations the NHS is discriminating against elderly patients by using ‘barriers’ to limit opportunities to see a family doctor face-to-face.
A recent poll involving more than 1,200 over-60s found 76 per cent had experienced difficulties in obtaining a face-to-face GP appointment for themselves or a relative.
Eight in ten reported being forced to accept a telephone consultation and 71 per cent begrudgingly saw another member of practice staff, while 18 per cent have gone to A&E after failing to secure an urgent GP appointment.
Silver Voices accused some practices of discriminating against the elderly by refusing walk-in bookings and telephone requests for repeat prescriptions.
Analysis of England’s 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 to?’, there has been a decline 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 per cent to 16 per cent while those who answered ‘never or almost never’ increased from 10 to 19 per cent.
Professor Stefan Scholtes, study co-author from Cambridge Judge Business School, said seeing the same doctor could have substantial benefits, equivalent to increasing the GP workforce by 5 per cent.
He said that ‘getting it right the first time’ will reduce future workloads by ‘preventing revisits’, adding: ‘Better health translates into less demand for future consultations. Prioritising continuity of care is crucial in enhancing productivity.’
GP leaders said continuity of care was ‘highly valued by GPs and patients alike’ but rising patients lists means the average GP now responsible for 260 more patients now than six years ago.
Dr Victoria Tzortziou-Brown, Vice Chair 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’s encouraging to see that this study has found it can also improve GP workload.
She 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 they were six years ago.
‘This is unsustainable and makes guaranteed access to the same GP for every patient practically impossible. However, it would be important that continuity of care is prioritised for those who need it the most.’
