Ongoing Decline in Continuity With GPs in English General Practices: A Longitudinal Study Across the COVID-19 Pandemic.

Purpose: Relationship continuity of care has declined across English primary health care, with cross-sectional and longitudinal variations between general practices predicted by population and service factors. We aimed to describe cross-sectional and longitudinal variations across the COVID-19 pandemic and determine whether practice factors predicted the variations.

Methods: We conducted a longitudinal, ecological study of English general practices during 2018-2022 with continuity data, excluding practices with fewer than 750 patients or National Health Service (NHS) payments exceeding £500 per patient.

Does shortage of GPs matter? A cross-sectional study of practice population life expectancy.

Background: There are not enough GPs in England. Access to general practice and continuity of care are declining.

Aim: To investigate whether practice characteristics are associated with life expectancy of practice populations.

Primary medical care continuity and patient mortality: a systematic review.

Background: A 2018 review into continuity of care with doctors in primary and secondary care concluded that mortality rates are lower with higher continuity of care.

Aim: This association was studied further to elucidate its strength and how causative mechanisms may work, specifically in the field of primary medical care.

Design And Setting: Systematic review of studies published in English or French from database and source inception to July 2019.

Examining the practice of generalist expertise: a qualitative study identifying constraints and solutions.

Objectives: Provision of person-centred generalist care is a core component of quality primary care systems. The World Health Organisation believes that a lack of generalist primary care is contributing to inefficiency, ineffectiveness and inequity in healthcare. In UK primary care, General Practitioners (GPs) are the largest group of practising generalists.

Generalist solutions to complex problems: generating practice-based evidence--the example of managing multi-morbidity.

Background: A growing proportion of people are living with long term conditions. The majority have more than one. Dealing with multi-morbidity is a complex problem for health systems: for those designing and implementing healthcare as well as for those providing the evidence informing practice.

Experienced continuity of care when patients see multiple clinicians: a qualitative metasummary.

Purpose: Continuity of care among different clinicians refers to consistent and coherent care management and good measures are needed. We conducted a metasummary of qualitative studies of patients' experience with care to identify measurable elements that recur over a variety of contexts and health conditions as the basis for a generic measure of management continuity.

Methods: From an initial list of 514 potential studies (1997-2007), 33 met our criteria of using qualitative methods and exploring patients' experiences of health care from various clinicians over time.

Service users' and caregivers' perspectives on continuity of care in out-of-hours primary care.

Modernization policies in primary care, such as the introduction of out-of-hours general practice cooperatives, signify a marked departure from many service users' traditional experiences of continuity of care. We report on a case study of accounts of service users with chronic conditions and their caregivers of continuity of care in an out-of-hours general practice cooperative in Ireland. Using Strauss and colleagues' Chronic Illness Trajectory Framework, we explored users' and caregivers' experiences of continuity in this context.

Management continuity in local health networks.

Introduction: Patients increasingly receive care from multiple providers in a variety of settings. They expect management continuity that crosses boundaries and bridges gaps in the healthcare system. To our knowledge, little research has been done to assess coordination across organizational and professional boundaries from the patients' perspective.

Progress with relationship continuity 2012, a British perspective.

This perspective paper makes a brief conceptual review of continuity and argues that relationship continuity is the most controversial type. Plentiful evidence of association with better satisfaction and outcomes urgently needs to be supplemented by studies of causation. The scope of these has been outlined in this paper.

Validation of a generic measure of continuity of care: when patients encounter several clinicians.

Purpose: Patients who regularly see more than one clinician for health problems risk discontinuity and fragmented care. Our objective was to develop and validate a generic measure of management continuity from the patient perspective.

Methods: Themes from 33 qualitative studies of patient experience with care from various clinicians were matched to existing instruments to identify potential measures and measurement gaps.

The ALFA (Activity Log Files Aggregation) toolkit: a method for precise observation of the consultation.

Background: There is a lack of tools to evaluate and compare Electronic patient record (EPR) systems to inform a rational choice or development agenda.

Objective: To develop a tool kit to measure the impact of different EPR system features on the consultation.

Methods: We first developed a specification to overcome the limitations of existing methods.

Interpersonal continuity of care: a cross-sectional survey of primary care patients' preferences and their experiences.

Background: Developments in primary care may make the provision of interpersonal continuity more difficult.

Aim: To identify those patients who regard interpersonal continuity as important and determine what makes it difficult for them to obtain this.

Design Of Study: Cross sectional survey.

How are different types of continuity achieved? A mixed methods longitudinal study.

Background: In the context of developments in healthcare services that emphasise swift access to care, concern has been expressed about whether and how continuity of care, particularly interpersonal continuity, will continue to be achieved.

Aim: To explore how patients regard and use primary care services in relation to continuity of provider and access to care, to identify factors that promote or hinder their success in achieving their preferences, and to describe what this means for how different types of continuity are achieved.

Design Of Study: Longitudinal, mixed methods.

Teaching evidence-based medicine to undergraduate medical students: a course integrating ethics, audit, management and clinical epidemiology.

A six-week full time course for third-year undergraduate medical students at Imperial College uniquely links evidence-based medicine (EBM) with ethics and the management of change in health services. It is mounted jointly by the Medical and Business Schools and features an experiential approach. Small teams of students use a problem-based strategy to address practical issues identified from a range of clinical placements in primary and secondary care settings.

General practice based teaching exchanges in Europe. Experiences from the EU Socrates programme 'primary health care'.

This paper reviews the experience of international exchange of medical students for general practice. The experience is based on the EU Socrates programme 'Primary Health Care' that offers, since 1992, clinical attachments and research electives in primary care. This programme involves 11 university departments of general practice/primary care in eight countries: Austria - Vienna; Belgium - Gent; Germany Düsseldorf; Italy - Monza, Udine; Netherlands Nijmegen; Slovenia - Ljubljana; Sweden - Göteborg; and the UK - Edinburgh, Imperial College London and Nottingham.

The impact of a student learning journal: a two-stage evaluation using the Nominal Group Technique.

Reflection offers a strategy that can help learners connect what they learn with their everyday practice. It can also assist them in taking control of their learning and in developing insight into the way that they learn. This study used the Nominal Group Technique to evaluate a reflective learning journal on a one-year course for GPs and pharmaceutical advisers.