Accessing Continuity
(2025 - ongoing)
Watch our video to learn more about the Accessing Continuity study
Relational continuity of care is the ongoing relationship between a patient and a healthcare provider. There is good evidence that continuity of care benefits patients, doctors, and the healthcare system. Despite its known benefits, continuity of care in general practice is declining. This may be due to the increasing demand for appointments and recent shifts in how patients access their general practice.
In the Accessing Continuity study, we will be exploring the level of continuity currently being delivered in general practice, and any associations between the continuity of care delivered and access systems being used. We are looking for one member of staff from each practice to participate.
All practices in the UK using either EMIS or SystmOne are eligible
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We are investigating the level of continuity of care currently being delivered in UK general practice and how this varies according to practice demographics. We are also exploring the associations between continuity of care and access systems in general practice. By access systems, we mean the in-practice mechanisms of managing supply and demand such as appointment availability, modality, length, clinician type and the use of triage systems.
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There have also been significant changes to the access systems used in general practice over recent years. This has been due to factors such as the increasing pressure to deliver immediate access to appointments and technological advances.
There has been very little research done to understand how these changes have impacted continuity of care. A better understanding is needed in order to inform healthcare policies and quality improvement going forward.
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We are asking for one participant from each general practice; any member of staff or student can participate.
If you participate, we will ask that you:
Measure the continuity of care in your practice using the Bristol Continuity of Care Calculator. You will receive training on how to use this tool and a user guide, so doing this should take no longer than 30 minutes.
Answer a questionnaire on the access systems used at your practice. You will need some input from the leadership team at your practice to do this, but it should take no longer than 30 minutes.
Consider participating in an interview, where we would discuss your thoughts on these topics in more detail. We will only interview a select number of participants. This would be done online at a convenient time for you.
We will also collect some demographic information about participating practices using publicly available resources.
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If you take part, you will:
Learn how to measure continuity of care in your practice and receive the tools to do so
Receive a bespoke practice report to see how your continuity scores compare to other practices
Fulfil CPD/portfolio requirements and be named as a collaborating author on resulting publications (subject to journal guidelines)
Help us gain a better understanding of how we can deliver better continuity of care to our patients
Access additional leadership opportunities, for example by becoming a PACT Accessing Continuity Champion
Co-principal investigators
Ethics approval
University of Bristol
Research Ethics Committee
(Favourable ethics opinion received)
Data collection
Funding and support
Dr Molly Dineen
ST3 Academic Clinical Fellow in General Practice (Bristol)
Centre for Academic Primary Care, University of Bristol
PPIE Small Award Fund
Primary care Academic CollaboraTive
Study adminstrative support and advertisement
Study timeline
Protocol development
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Ethics approval and study advertisement
Recruitment
starts
Data analysis
PACT practice reports
Publication and dissemination of results
Dr Hannah Mahoney
ST3 Academic Clinical Fellow in General Practice (Bristol)
Publications and communications
Dineen M, Engamba S, Khan NF, Sidaway-Lee K, Duncan P, Watson J, et al. Delivering relational continuity of care in light of recent GP contract changes. BJGP. 2025;75(757):342–4. [Publication]
