Controversy in primary care: does continuity in general practice really matter?

Continuity is an official core value of general practice in the United Kingdom,1 but there are at least two potentially conflicting definitions of it. Both definitions are powerfully expressed in a recent report from the BMA, entitled Shaping Tomorrow.2 For general practitioners, continuity of care has traditionally meant that a patient visits the same doctor.3,4 What matters is personal continuity, in which an ongoing doctor-patient relationship ensures that care takes account of the patient's personal and social context. By contrast, recent statements from the NHS Executive emphasise the importance of consistency and coordination of care.5 From this perspective, continuity can be enhanced by appropriate organisation, guidelines, and electronic medical records, irrespective of which doctor is see