Seeing same GP could reduce hospital admissions, study shows

Access to the full content of this site is available only to registered healthcare professionals. Register to read more

Seeing the same GP could reduce hospital admissions among older patients, a study in the British Medical Journal (BMJ) has found.

Researchers at the Health Foundation charity analyzed data for more than 230,000 people in England aged between 62 and 82, and found that older patients who were mostly seen by the same GP were admitted to hospital 12% less than those patients who had a lower continuity of care.

This association was particularly pronounced among frequent users of primary care who visited their GP more than 18 times over the 2-year study period between April 2011 and March 2013.

The study looked at ambulatory care sensitive conditions such as asthma, gangrene, flu and pneumonia, which can be treated in doctors’ surgeries. In 2009/10 the NHS spent £1.42 billion on hospital admissions for these types of illness.

The authors write that the government’s focus on increasing access to GPs may have unintentionally affected the continuity of care in general practice, and that improving this ‘may reduce secondary care costs, particularly for the heaviest users of healthcare’.

The government introduced changes in 2014 to ensure all patients in England have a named GP accountable for their treatment. However, in an accompanying editorial for the BMJ, researchers at the University of Bristol said ‘there is evidence that continuity of primary care is actually declining in the UK’.

‘A primary care system that is increasingly fragmented, in which neither patients nor doctors feel strongly connected to their local general practice, provides the setting for patients to choose to attend an emergency department,’ they said.

They are calling for policies to enable greater continuity of care, saying that greater contact between a patient and GP ‘builds trust and a sense of mutual responsibility’, would improve doctors’ job satisfaction and would be ‘very likely’ to reduce pressure on hospitals.

A spokeswoman for the Department of Health said: ‘This government is committed to making sure patients can get the right care at the right time from well-resourced GPs and, from April 2015, all patients have had the right to continuity of care through a named GP, as part of the GP contract.

‘This remains a key part of our plan to reduce pressure on hospitals, and is in no way diminished by extending access.’