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Opinion Primary Colour

Helen Salisbury: Holding on to what makes general practice special

BMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o2002 (Published 30 August 2022) Cite this as: BMJ 2022;378:o2002

Rapid Response:

Re: Helen Salisbury: Holding on to what makes general practice special

Dear Editor

As usual Dr Salisbury makes some excellent observations. As a GP working in the same region, I too (along with colleagues) have reacted with some dismay to this (understandable) change in policy.

Although Dr Salisbury alludes to it in the article, I think it bears repeating - this is yet another blow to continuity of care, the value of which is hard to measure and easy to underestimate.

With this particular policy change, there might of course be something in an increase in continuity, with at least during the pregnancy. But I would argue that the relationship built up with a GP during what is more often than not a routine ante-natal period can be vital after delivery. Health problems such as postnatal depression may not present until long after the midwives have discharged the patient, and a trusting relationship with a GP, developed during the antenatal period, might be the difference between early presentation and identification of an issue or not.

No doubt, as in many other areas where continuity with our patients has been eroded, new systems, pathways and protocols (and staff) will spring up to plug this loss. But somehow it just feels like yet another blow to what helped make British general practice such a strong model of primary care.

Competing interests: No competing interests

05 September 2022
Daniel A Faller
General practitioner
The Rycote Practice, Thame