QUERCC
Research type
Research Study
Full title
Quantifying, Understanding and Enhancing Relational Continuity of Care
IRAS ID
329566
Contact name
T P Marshall
Contact email
Sponsor organisation
University of Birmingham
Duration of Study in the UK
years, 36 months, days
Research summary
Relational continuity of care (RCC) is where patients see the same clinicians over time. It is valued by patients and General Practitioners, and evidence suggests continuity results in better health care delivery and better health. Continuity has been declining in recent years. This may be linked to the growth in size of general practices, more doctors working part-time or moving practice. It may also be because general practices focus on patient access, rather than continuity.
Our research aims to develop resources to help General Practitioners measure, manage and improve continuity of care. We will achieve this in five steps as follows:
First, we will host consensus workshops of patients, primary care clinicians and researchers to work out how best to measure RCC.
Second, we will review national data to look at the how staff turnover, part-time working, practice size and funding per patient affects continuity. From this work we will see which practices have higher than average RCC.
Third, we will carry out case studies at sample of the practices with higher-than-average RCC. The case studies will look at staff and patient experience, the use of information, and practice policies. Findings will be used to document the barriers and facilitators for establishing RCC. We will compare our findings with those detailed in the General Practice Patient Survey (GPPS).
Fourth, we will look at resource costs and health outcomes, using linked primary and secondary care data. This will show whether costs influence continuity for different patient groups (by age, sex, deprivation status and chronic disease status).
Fifth, we will develop practical guidance to improve continuity of care, based on the findings from each stage of the research. We will work with the Royal College of General Practitioners (RCGP) and Patient and public involvement (PPI) advisors to ensure our research delivers outcomes relevant to patients and practitioners.
Debates about relational continuity of care have previously been led by clinicians and researchers. A key benefit of our work is involvement of the public in workshops on measurement of relational continuity of care and in synthesising the findings at the end of the project.
In this application we provide details of the first step (consensus workshops) for ethical review and will make submissions and seek approval for the other four steps as separate applications.REC name
South West - Central Bristol Research Ethics Committee
REC reference
23/SW/0101
Date of REC Opinion
31 Jul 2023
REC opinion
Favourable Opinion