The Common’s Health and Social Care Committee published a report last year –The future of general practice – recommending the restoration of a closer doctor-patient relationship. However the government said that it was down to each practice to decide the best way to meet the needs of patients.
While the majority of the committee’s recommendations were accepted, in whole or in part, those associated with continuity of care were consistently rejected.
The committee had proposed the development of a national measure of continuity of care to be reported by all GP practices by 2024. It suggested this could be based on existing models, such as the usual provider continuity index and the St Leonard’s index of continuity of care.
The government’s response acknowledged the value of promoting and tracking continuity to improve patient care. However, it argued that the approaches proposed by the committee did not define continuity of care in a way that reflected the complex interactions between GPs and multi-disciplinary teams at a national level.
In addition, the response argued that a national measure needs to balance increased continuity for patients most in need with giving individual practices the freedom to best use their time and skills. This meant that more time was needed to design an appropriate measure and it was impractical to commit to introducing one by 2024.
The committee also recommended reintroducing the personal list model for GPs, which meant that patients registered with individual GPs rather than practices and was standard prior to 2004.
The government’s rejected this recommendation outright, claiming that it would compromise practices’ ability to meet patient needs, work at scale, and form partnerships with non-GP professionals. The response also highlighted the use of named GPs in the current system, which required practices to make ‘reasonable efforts’ to assign patients to individual GPs if they requested. This allowed for some of the continuity benefits of assigned GPs without limiting practices’ flexibility to meet their own patients’ needs.
Steve Brine (pictured), the committee’s chair said he welcomed the ‘very positive response to many of our recommendations on general practice’. However, he added: ‘What’s disappointing is that ministers have rejected a series of measures intended to restore the doctor-patient relationship to the heart of general practice. The inquiry heard strong evidence to support continuity of care and we hoped to see NHS England championing the personal-list model as one way to help achieve that.’
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