Improving personal continuity in general practice: a focus group study

Area of Science:

• General Practice
• Healthcare Management
• Patient Care Continuity

Background:

• Personal continuity in general practice enhances care quality and reduces mortality.
• Societal and healthcare changes challenge personal continuity, disproportionately affecting older patients.
• Discontinuous care negatively impacts older individuals.

Purpose of the Study:

• To explore perspectives on improving personal continuity in general practice.
• To identify barriers and facilitators to enhancing personal continuity.
• To understand the roles of GPs, older patients, practice nurses, and assistants.

Main Methods:

• Qualitative study utilizing focus groups (May-August 2019).
• Four focus groups conducted: GPs (n=17), patients (n=7), practice assistants (n=4), and practice nurses (n=2).
• Reflexive thematic analysis applied to focus group data.

Main Results:

• Personal continuity is a team effort, not solely the GP's responsibility.
• Improving continuity involves enhancing team communication, utilizing electronic health records, and ensuring GP accessibility for frail older patients.
• Barriers exist at individual, organizational (e.g., staff shortages), and societal levels (e.g., payment systems).

Conclusions:

• General practice is shifting towards team-based care for personal continuity.
• Efforts to improve personal continuity should support this team-based model.
• Focusing on team-based provision of continuous care is essential.