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- Page navigation anchor for RE: Response to eLetter 13 June 2024 from Denis J Pereira Gray et al.RE: Response to eLetter 13 June 2024 from Denis J Pereira Gray et al.
Thanks for your letter dated 13 June 2024. We’re very sorry for the delayed response which is due to prolonged sickness absence of the corresponding author last year. We acknowledge your significant contribution to this field and are grateful for you taking the time to write a letter in response to our article.
You raised three issues which we have addressed in turn.
The aim of our review was to find evidence on how to deliver relational continuity of care. We did not set out to find data on the outcome of interventions. Our study was unfunded, and going beyond our scope to include the extraction of outcome data would have exceeded the capacity of the reviewing team. We acknowledge this as a limitation of the study, but we feel strongly that a well conducted study with limited scope is better than no published study at all. We hope that our article is a valuable addition to the literature and would welcome further funded systematic reviews on the topic.
We extracted information from page 72 of the Health Foundation report (Continuity Counts, 2022) which stated “The project has been focused on increasing continuity of care in General Practice for all patients, although in one practice did choose to also consider patients who were ‘frequent attenders’.”
Although this paper looks at a practice which uses a personal list system, its main method was a quantitative analysis of appointment data and therefore met one of our exclusion criteria:...
Show MoreCompeting Interests: PB is the Ethics Advisor for BJGP Open and is on the Editorial Board. He had no role in the decisionmaking process on this manuscript. - Page navigation anchor for Relational ContinuityRelational Continuity
Sir / Madam,
We welcome Fox et al’s scoping review of relational continuity as it studies a subject of increasing importance. However, we note some limitations in some of their methods and conclusions. Whilst we understand that scoping reviewers may choose to not include results of the studies found, this decision does limit their value.
With the caveat that we are writing without the benefit of access to the supplemental data, they present no numerical results for continuity achieved by any method so their readers cannot know how much is possible in clinical practice. Although not all reports contain numerical results, some do, and these could have been included even if comparison is not possible. They weaken the impact of the study by considering only methods and not outcomes.
Secondly, they have stated that during our Health Foundation project — Continuity Counts, 2022 — one practice targeted frequent attenders. This was not the case as all practices attempted to provide continuity to their entire registered populations and this was what was measured and reported.
Finally, based on their eligibility criteria, we are not sure why our study from 2019 (Sidaway-Lee et al) was not included. This was a peer-reviewed report featuring a UK general practice as a case study, using personal lists as a method to improve relational continuity. It reported two years’ continuity results using both the SLICC and the UPC.
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Fox MN, Dick...Competing Interests: We ran the Health Foundation project mentioned in the letter and were the authors of Sidaway-Lee et al 2019.
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