Continuity of care in general practice multi-disciplinary teams: understanding the impact of pharmacy roles and measuring continuity across the wider team

PI Lead: Dr Nada Khan

Lead Member: University of Exeter

Traditional general practice care involves a family doctor, or GP, looking after a group or a list of patients. This allows GPs and patients to build long-term relationships over many years. This approach is called ‘continuity of care’. It describes the trusting
relationship between a doctor and a patient. Patients who have high levels of continuity of care can experience better outcomes from their care in general practices. For instance, they experience better prescribing of medicines, more satisfaction with their care, fewer admissions to hospital and even live longer.

General practice, and how practices receive money, is rapidly changing, with more people from different professional backgrounds working as part of the general practice team. For instance, patients may now see a pharmacist for some of their care (e.g. medicines prescribing and management) that in the past would have involved seeing their GP.

We don’t know how continuity of care is affected, or can be maintained, when more than one person is responsible for a patient’s care. This project aims to look at continuity of care when more professionals are caring for patients in general practice.

The first part of the study will find out what patients, GPs, pharmacists think about continuity of care, when care in general practice is provided by a wider professional team. To do this, we will interview patients, GPs and pharmacists about their ways of
working in a team and sharing information. We want to better understand how GPs and pharmacists communicate about and coordinate their patient’s care to support continuity. We will also ask patients what they think about having different
people coordinate their care.

In order to see how well a general practice is providing continuity of care, we need to be able to measure it. Current ways of measuring continuity of care typically assume only a relationship between a GP and their list, or group, of patients. However, this isn’t the way that many general practices now work, especially with professionals other than GPs seeing patients. The second part of this project therefore looks to develop a way to measure continuity of care amongst teams of professionals
working in general practice. We will do this by speaking to patients, GPs, pharmacists and researchers with experience of measuring continuity of care and getting their opinions about the best way to do this. If we can measure continuity of care
amongst general practice teams, we can see how well a practice is doing to provide this kind of care. If we can measure continuity, we can then work to improve it. We will develop recommendations for ways to measure continuity of care and will aim to test these out in future research projects.