Continuity of care should be the priority issue for general practice, survey reveals

Over half (57 per cent) of GPs and other practice-based professionals surveyed by The King's Fund said that providing continuity of care should be the main priority for improving the quality of general practice in England.

The King's Fund commissioned the survey earlier this year among GPs and practice-based professionals to provide a snapshot of views from the front line to complement its Inquiry into the Quality of General Practice in England. The survey sought to gain the opinions of GPs and practice-based professionals on the extent to which general practice is currently providing high-quality patient care.

In contrast, just one in five (20 per cent) thought that access to care should be prioritised, despite its strong focus in recent debate on health reform – particularly out-of-hours access, electronic booking and appointment waiting times. The findings are consistent with recent research for the Fund that showed patients would generally opt for better continuity of care over speed of access when given a choice. Many GPs said that quality gains could be made by spending more time with patients and through better co-ordination of care.

Managing long-term conditions was identified as the second place by 40 per cent of respondents, with health prevention a priority for 28 per cent and end-of-life care for 25 per cent.

We also asked about the impact of different methods for quality improvement and which approaches GPs believed are most and least likely to improve quality:

  • 65 per cent of respondents believed that clinical best practice guidance is the most effective approach to improving quality, followed by pay-for-performance mechanisms, such as Quality Outcomes Framework (QOF)
  • 57 per cent of respondents thought that patient surveys are the least effective approach to quality improvement, followed by revalidation (54 per cent) and balanced scorecards (53 per cent). 

However, it is not clear whether GPs' views about the impact of patient surveys suggested they do not value the views of patients, or whether their opinions simply reflected concerns about the way that surveys are carried out or how data is presented.

Nick Goodwin, senior fellow at The King's Fund and director of the GP Inquiry, said:

'While access to GP services is clearly important and has been the focus of recent NHS reforms, GPs and patients alike are telling us that continuity of care should be a significant aspect in delivering quality improvements in general practice. 

'The findings also raise some important questions about how best to drive quality improvement. Are pay-for-performance measures really a more important tool for quality improvement than other quality improvement initiatives such as patient feedback or practice accreditation? Does this suggest that GPs are less willing to embrace greater transparency to the public and their peers in the quality of care they provide?'

Findings from The King’s Fund’s Inquiry into the Quality of General Practice in England, undertaken by an independent panel, will be published in the New Year.

Notes to editors: 

  1. For further information, please contact The King’s Fund press and public affairs office on 020 7307 2585. If you are calling out of hours, please ring 07584 146035.
  2. Methodology: The survey was carried out using Survey Monkey and completed in March 2010. 843 individuals working in general practice responded; however, we do not claim it is representative of the views of general practice.
  3. Respondents included:
    GP partners
    Salaried GPs
    GP registrars
    GP locum/sessional GPs
    Practice managers
    Nurses employed in general practice
  4. The King’s Fund is a charity that seeks to understand how the health system in England can be improved. Using that insight, we help to shape policy, transform services and bring about behaviour change. Our work includes research, analysis, leadership development and service improvement. We also offer a wide range of resources to help everyone working in health to share knowledge, learning and ideas.