Is Adopting a Microteams Model a Solution to Delivering Continuity of Care in Modern Primary Care?

Abstract

BackgroundThere is extensive literature on the benefits of Continuity of Care (CoC) with the same General Practitioner (GP), including improved healthcare outcomes, increased satisfaction, and reduced costs. Models such as microteams are being explored to sustain continuity amid rising demand and workforce challenges. However, there is limited evidence describing their implementation or the monitoring of continuity during organisational change.AimTo describe a real-world approach to implementing microteams and monitoring CoC, and to explore the association between microteam implementation and CoC within a large Primary Care Network (PCN).Design and SettingObservational before-and-after study conducted in a large multi-site PCN serving 46,500 patients across eight sites between March 2022 and March 2024.MethodCoC was measured using the Usual Provider of Care (UPC) index, representing the proportion of consultations with the same GP or GPs within a microteam. UPC scores before implementation (March 2022-March 2023) were compared with scores after implementation (March 2023-March 2024) using t-tests.ResultsTwelve microteams were implemented across the PCN. Among patients with ≥3 GP appointments, the UPC score increased from 0.034 to 0.358 (p<0.001). Across all patients with GP appointments, the UPC score increased from 0.033 to 0.375 (p<0.001). Excluding urgent care appointments produced similar results (UPC 0.355). Patient satisfaction also improved following implementation, although findings should be interpreted in the context of concurrent organisational changes, including a practice merger.ConclusionMicroteams can be implemented within a large multi-site PCN, and continuity of care can be monitored using routinely collected data. Implementation was associated with substantially higher UPC scores, suggesting improved team-based continuity. Although causality cannot be inferred from this uncontrolled service evaluation, the model may provide a pragmatic approach to supporting continuity in large multidisciplinary primary care organisations.