Seeing the same GP improves patients’ health, reduces doctors’ workloads and could free up millions of appointments, according to the largest study of its kind.
Primary care is under enormous strain, with patients struggling to book consultations, GPs quitting or retiring early, and financial pressures causing some practices to close. Four-week waits hit a record high in 2023, with 17.6m appointments taking place at least 28 days after being booked in England last year.
Research has previously suggested there may be benefits to seeing the same family doctor. But studies have mostly been small or covered a short period of time. Now University of Cambridge and Insead business school researchers have analysed data from 10m consultations over more than a decade in the most authoritative study on the issue yet.
They found that if all GP practices moved to a model where patients saw the same doctor at each visit, it would significantly reduce doctors’ workloads while improving patient health. Multiple benefits emerged when patients had a long-term relationship with their doctor, researchers found.
Seeing the same GP – known as continuity of care – meant people waited on average 18% longer between visits, compared with patients who saw different doctors.
People did not take up more GP time in each consultation and the findings were particularly strong for older patients, those with multiple chronic illnesses, and people with mental health conditions.
Although it will not always be possible for people to see their regular GP, researchers said the findings would translate to an estimated 5% reduction in consultations if all practices provided the level of continuity of care of the best 10% of practices. That suggests millions of appointments could be freed up.
The researchers added: “Importantly, if patients receiving care from their regular doctors have longer intervals between consultations without requiring longer consultations, then continuity of care can potentially allow physicians to expand their patient list without increasing their time commitment.”
In the study published in the journal Management Science, experts analysed 10m consultations across 381 practices in England over 11 years.
The study said: “A physician can be considered more productive if they improve the quality of care provided without reducing the number of patients they serve per year or if they serve more patients without reducing quality of care.
“In primary care, where patients often have a preferred doctor, these two dimensions are related.
“If physicians provide high-quality care to their regular patients, they are likely to keep them healthier, which reduces the demand for consultations and increases their capacity to serve more patients.”
Analysis of England’s GP patient survey data by the Nuffield Trust showed that when asked “how often do you see or speak to your preferred GP when you would like to?”, continuity of care has declined over time.
Between 2018 and 2023, the proportion of patients who “always or almost always” saw or spoke to their preferred GP decreased from 26% to 16% while those who answered “never or almost never” increased from 10% to 19%.
A co-author of the study, Prof Stefan Scholtes, from Cambridge Judge Business School, said seeing the same doctor could have enormous benefits.
“The impact is substantial: it could be the equivalent of increasing the GP workforce by 5%, which would significantly benefit both patients and the NHS,” he said. “Better health translates into less demand for future consultations. Prioritising continuity of care is crucial in enhancing productivity.”
The UK has a major shortfall of GPs, according to the Health Foundation and the Nuffield Trust, with thousands more medics needed to meet demand. In the US, the Association of American Medical Colleges estimates a shortfall of up to 55,200 primary care physicians by 2033.
“Getting it right the first time” would reduce GPs’ future workloads by “preventing revisits”, Prof Scholtes added.
In the study, researchers used anonymised data from the Clinical Practice Research Datalink, consisting of more than 10m GP visits between 1 January 2007 and 31 December 2017. The study restricted itself to patients who had at least three consultations over the previous two years.
Dr Harshita Kajaria-Montag, lead author of the new study, who is now based at the Kelley School of Business at Indiana University in the US, said: “The benefits of continuity of care are obvious from a relationship point of view.
“If you’re a patient with complex health needs, you don’t want to have to explain your whole health history at every appointment. If you have a regular doctor who’s familiar with your history, it’s a far more efficient use of time, for doctor and patient.”
Dr Victoria Tzortziou-Brown, vice-chair of the Royal College of GPs, said continuity of care was “highly valued by GPs and patients alike”, adding: “Studies such as this one are very important for informing future policy and practice.
“Currently, the intense workload and workforce pressures GPs are facing – as well as political agendas prioritising speedy access to GP services above all else – greatly limit the level of continuity we can offer.”
