The One Care continuity of care programme draws to a close this month. Despite the challenges posed by Covid, 23 practices took part in the project and each embarked on their own continuity of care journey. All hints and tips from the practices have been captured in a resource toolkit which will soon be hosted on the RCGP website shortly. Our data shows practices were able to improve their continuity by up to 15% across their practice list. There were even greater improvements in continuity where the focus was on a particular cohort of patients.

We’ve built a timeline of the project, which can be found here:

One of the primary  outputs of this project is a resource toolkit to help implement continuity of care in the practice. The toolkit provides:

• Practical suggestions on how to improve continuity.
  A way to measure continuity using the Usual GP Measuring Tool, developed by One Care Digital Team.  There are 4 measures available in this easy-to-use Tool.  The Tool is based on consultation activity and shows how consultation activity is spread across your practice.  For example, you will be able to see if your frequently attending patients are shared evenly across the team.
• Communication material including leaflets and posters together with an animation which you can show on our website or in the waiting room.
  The Resource Toolkit is currently on One Care Team Net but later this month it will be hosted on the Royal College of GPs (RCGP) website, following the demonstration at this year’s RCGP conference and testing by practices across England and Scotland.
  Our practices approached continuity in different ways from those who had already have personal lists looking to further improve continuity, to those testing microteam approaches, to those focusing on a particular cohort of patients. Our data shows practices able to improve their continuity by up to 15% across their practice list.  Even greater improvements were made where the focus was a particular cohort of patients.

As a project we learned:

• Through our surveys and conversations that continuity matters to both patients and staff
• Practices regardless of their list size can achieve good levels of continuity, including those that are multi-site.
• Where the practice has continuity of care processes in place, GPs on low sessions achieve continuity levels on par with GP working a high number of sessions.
• Practices in deprived areas of Bristol can achieve good levels of continuity.
• Focusing on a small cohort of patients, has a ripple effect so overall continuity at the practice improves.

We’d like to thank all the practices who were able to take part, and look forward to seeing the impact continuity plays on patients in BNSSG going forward.