Personal Views

Continuity of care—sacred cow or vital necessity?

BMJ 1995; 310 doi: (Published 29 April 1995) Cite this as: BMJ 1995;310:1144
  1. Christopher Bulstrode

    The new deal on junior doctors' hours and the recommendations of the Calman report on specialist medical training will require a radical review of working practices in hospital. Not only will juniors be working fewer hours but as a result of shortened training there will be fewer of them available to provide a service. The medical work in hospitals will inevitably become more consultant based. The old system of a firm, built on a consultant leading a team of juniors, looks as if it may be the first casualty, replaced by a team of consultants and a shrinking pool of juniors. The benefits of continuity of care, provided by the juniors working long hours, will have to be provided in some other way.

    The importance of continuity of care for training and patient care is now being presented to our regional task force as one of the most cogent reasons why the present changes are ill considered and unworkable. But before condemning these changes out of hand it may be worth considering the real meaning of continuity of care and …

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