Continuity of care in UK primary care: a scoping review of measures, challenges, and future interventions

Journal article

Background: Continuity of care refers to the consistent and coordinated delivery of healthcare services over time. Continuity has been associated with improvements in morbidity and mortality, yet its decline has been identified as a significant concern amid increasing pressures in primary care.

Aim: This review aimed to inform current policy initiatives by synthesising evidence on how continuity of care is measured, the current challenges faced and proposed future interventions in UK general practice.

Methods: We conducted a literature search for articles published before 15 February 2024, to explore continuity in UK primary care. Screening and data extraction followed PRISMA Scoping Review guidelines, with all studies undergoing double screening to determine eligibility.

Findings: A total of 180 papers were included (95 quantitative, 76 qualitative and 9 mixed-methods). Across the literature, continuity of care was most commonly conceptualised and measured as relational continuity, with informational and managerial continuity rarely assessed. Certain patient groups, including those with long-term conditions and multimorbidity, were reported to place greater value on continuity of care. Higher relational continuity was associated with improved patient satisfaction, care coordination and reduced hospital admissions. However, sustaining continuity was frequently challenged by workforce pressures and fragmented information transfer. Although formal and informal interventions to enhance continuity were described, tensions between continuity and access persisted, and continuity was reported to vary across patient groups.

Conclusion: The decline in continuity of care has implications for patient experience and system outcomes. This review highlights the need for system-level approaches to support continuity, while addressing workforce constraints, access pressures and unequal experiences of care. Further research is needed to evaluate the effectiveness and sustainability of continuity-enhancing interventions and to identify any potential unintended consequences.

Authors: Kartikapallil, N; Arroyave, NC; Taylor, J; Sanghera, I; Alam, MR

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Cambridge University Press
• Journal: Primary Health Care Research and Development
• Volume: 27
• Article number: e55
• Publication date: 2026-05-06
• Acceptance date: 2026-03-30
• DOI: 10.1017/s1463423626101212
• EISSN: 1477-1128
• ISSN: 1463-4236
• Language: English
• Keywords: primary care; general practice; general practitioner; continuity; continuity of care; healthcare delivery; health policy; patient outcomes