Project 827 | Continuity of care, equity, and health outcomes: A national routine data study

Is general practice more fragmented for patients experiencing socio-economic deprivation and ethnic minority groups and does it worsen their health? A national routine data study

Seeing the same GP over time is called GP continuity. Research shows GP continuity can help people to follow treatment plans and reduce hospital visits. But people in poorer areas, or from minority ethnic groups, are less likely to see the same GP regularly. We do not know how this affects their health.

People with long‑term conditions, like diabetes, often see nurses and pharmacists as well as GPs. We do not know if their health improves when they see the same nurse each time, or when they regularly see the same team of health professionals. We do not know whether some patient groups have less continuity with nurses and teams.

STUDY QUESTIONS
1. Does seeing the same GP reduce emergency or unplanned hospital visits?
2. For adults with diabetes:
     a. Does seeing the same nurse improve control of their diabetes?
     b. Does seeing the same team of professionals improve control of their diabetes?
3. For all the above, does this differ between patient groups?

HOW WE WILL ANSWER STUDY QUESTIONS

We will use anonymous data from GP practices, covering 10 million adults in the UK, linked to hospital records. We will measure how often people see the same GP and compare this with how often they visit the hospital or emergency department. For people with diabetes, we will measure how often they see the same GP, nurse, pharmacist, and healthcare team. We will then look at links between continuity and health outcomes, including blood sugar levels, blood pressure, medicines, and hospital use. Finally, we will explore whether continuity and health outcomes differ by age, gender, ethnic group, deprivation, and number of illnesses.

BENEFITS AND IMPACT

Patients and the public helped design this study and will stay involved to keep it relevant and easy to understand. Our findings will show which groups have lower continuity and whether this is linked to poorer health. This could help target support to improve continuity and reduce health inequalities. If we show nurse continuity improves health, it could help practices to improve care. We will share results using pictures, charts, newsletters, meetings, and scientific papers.