UCL School of Management is delighted to welcome Michael Freeman from INSEAD, to host a research seminar discussing ‘The Operational Determinants of Relational Continuity of Care: An Empirical Study of Primary Care in the UK’
Problem Specification: Maintaining an ongoing relationship between a patient and provider, referred to as relational continuity (RC), is advocated as a cornerstone of primary care. While RC in primary care is known to confer many clinical and operational benefits, what remains less clear is which factors affect a primary care practice’s ability to provide RC to its patients? This paper examines this question from an operations management perspective by exploring the relative importance of two operational factors that may explain variation in rates of RC between practices and over time: workload changes and workforce fragmentation.
Practitioner Audience: This paper helps practice managers to identify the root cause of low rates of RC at their practice and the key operational levers that they can use to promote RC.
Core Insight: We find that a sustained increase in workload - caused by demand growth - and increasing fragmentation of the workforce - due to a shift to part-time and agency work - induces significant heterogeneity between practices in their ability to provide RC. In fact, these factors alone can also explain more than 50% of the decline in RC over the past decade, with workforce fragmentation having a relatively greater impact than demand growth.
Practical Implications: Practice managers must improve the attractiveness of full-time salaried employment if they wish to promote RC. Meanwhile, strategies to curtail demand are less effective and more challenging to achieve in practice.