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Delivering relational continuity of care in UK general practice: a scoping review

Miglena N Fox, Jon M Dickson, Patrick Burch, Daniel Hind and Olivia Hawksworth
BJGP Open 2024; 8 (2): BJGPO.2024.0041. DOI: https://doi.org/10.3399/BJGPO.2024.0041
Miglena N Fox
1 Centre for Health and Related Research, University of Sheffield, Sheffield, UK
2 Medicine Optimisation Team, South Yorkshire Integrated Care Board, SY ICB, Sheffield, UK
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Jon M Dickson
3 Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK
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  • For correspondence: j.m.dickson@sheffield.ac.uk
Patrick Burch
4 Centre for Primary Care, University of Manchester, Manchester, UK
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Daniel Hind
3 Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK
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Olivia Hawksworth
3 Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK
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    Figure 1. PRISMA flow chart
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    Figure 2. Patient profiling. NT = Nuffield Trust; THF = The Health Foundation
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    Figure 3. Implementation strategies. Please note, ‘n’ represents the number of studies the said implementation strategy was used in, that is, if n = 0, it means that the said strategy was not used in any of the interventions. The pale blue highlighting is solely to help with the readability and segregation of the individual strategies.
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    Figure 4. Programme theory model

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    Table 1. Location and population characteristics
    Study IDWherePopulationRelevant population characteristics
    Tammes, 2019, Barker 2016(cohorts)27,28 England (Tammes: 139 English GP practices), (Barker: 200 general practices)Tammes: a random sample of 27 500 patientsBarker: 255 469 patientsTammes: patients who were aged 65–84 years in 2012Barker: patients aged between 65 and 85, after excluding those aged 75.
    Slater, 2021(mixed-methods study)29 Scotland4000 patientsDeprived area
    Salisbury, 2019(randomised controlled trial)30 33 general practices located in three areas of England and Scotland: Manchester, Bristol, and Ayrshire and ArranA total of 1546 patients were enrolled in the study, with 797 patients assigned to the 3D intervention from 16 practices, and 749 patients assigned to usual care from 17 practicesA diverse range of locations, encompassing both affluent and deprived areas, as well as rural, urban, and suburban areas
    The Health Foundation, 2022, five case studies: Continuity counts31 One practice was located in Exmouth, one in mid-Devon (rural location), and the other three in ExeterTotal population of 41 129 peopleNo data
    The Health Foundation, 2022, five case studies: Morecambe Bay Primary Care Collaborative (MBPCC)31 10 practices in South Cumbria and Morecambe BayPopulation of 97 275No data
    The Health Foundation, 2022, five case studies; One care31 23 practices in North Somerset, South Gloucester, and BristolPopulation of around 400 000 patientsBoth deprived and affluent backgrounds, as well as individuals from rural and urban environments
    The Health Foundation, 2022, five case studies: Continuity by design (Pier Health Partnership)31 Weston and Worle locality in the South West of EnglandPopulation of 94 000 patientsWeston-super-Mare is recognised for its challenges related to GP shortages, large patient lists, high patient demand, significant workload, and ongoing difficulties with GP recruitment
    The Health Foundation, 2022, five case studies: Valentine Health Partnership31 Woolwich, South East LondonPopulation of >26 000 patientsYounger and ethnically diverse transient population. The population of this partnership is changing often and is increasingly socioeconomically diverse
    Nuffield Trust, 2022, four case studies: AT Group Digital Hub32 Greater LondonTotal registered population of 420 000 patientsNo data
    Nuffield Trust, 2022, four case studies: St Austell Healthcare32 Five sites in St Austell, CornwallPopulation of 36 800 patientsMainly urban or suburban areas, including one rural and deprivation group 5 with a high levels of chronic disease
    Nuffield Trust, 2022, four case studies: Quay Health Solutions32 North Southwark, LondonPopulation of 200 000 patientsTop two deprivation decile
    Nuffield Trust, 2022, four case studies: Foundry Healthcare32 Nuffield Trust, 2018, evidence review, Lewes, East Sussex33 Lewes, East SussexPopulation of 28 200 across five sitesUrban and rural communities with deprivation decile 8
    Nuffield Trust, 2018, evidence review, Fleetwood, case study33 3 GP practices in town of FleetwoodAround 30 000 patientsNo data
    Nuffield Trust, 2018, evidence review, Larwood and Bawtry, case study33 Larwood, 5 sitesPopulation of 32 800 patientsNo data
    Nuffield Trust, 2018, evidence review, Southampton case study33 26 GP practices in Southampton269 000 patientsNo data
    Nuffield Trust, 2018, evidence review, Richmond, case study33 28 GP practices in Richmond, London215 000 populationNo data
    Nuffield Trust, 2018, evidence review, Littlehampton, case study33 The Park surgery in LittlehamptonPopulation of 10 000High proportion of older people
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Delivering relational continuity of care in UK general practice: a scoping review
Miglena N Fox, Jon M Dickson, Patrick Burch, Daniel Hind, Olivia Hawksworth
BJGP Open 2024; 8 (2): BJGPO.2024.0041. DOI: 10.3399/BJGPO.2024.0041

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Delivering relational continuity of care in UK general practice: a scoping review
Miglena N Fox, Jon M Dickson, Patrick Burch, Daniel Hind, Olivia Hawksworth
BJGP Open 2024; 8 (2): BJGPO.2024.0041. DOI: 10.3399/BJGPO.2024.0041
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Keywords

  • general practice
  • continuity of patient care
  • Primary health care

More in this TOC Section

  • Podcasting in primary care: attitudes of Scottish GP specialty trainees and trainers towards podcast-based education in primary care
  • Patient perceptions of relational continuity in England: insights from two cross-sectional surveys
  • COVID-19 and patient-reported experience of general practice in England
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