The merger of general practices in England to cover more patients at fewer, but larger, sites has failed to produce the intended outcomes, British researchers claim.

The findings are based on patient reports of their experiences, such as waiting times, at these practices.

Professor Lindsay Forbes of the University of Kent, UK, and colleagues analysed information from 2013 to 2018 contained in the UK GP Patient Survey, which is completed by several hundred thousand people annually. Results from the 644 practices which expanded by more than 20%, showed that the proportion of patients who could see their choice of GP fell from 59% to 49%. At the 5,602 practices that stayed about the same size, the proportion also fell but by a smaller amount, 63% to 56%.

The study also showed that the expanded practices failed to achieve better access to care or provide a better overall experience. The study published in the British Journal of General Practice yesterday (3 November).

Professor Forbes said: “Larger general practice size in England may well be associated with slightly poorer continuity of care and may not improve patient access. This goes to show that bigger may not be better with English primary care. Better health outcomes for individuals and patient experience for those with long-term conditions must be prioritised.

“Continuity of care is an important feature of good quality primary care and it is vital that we preserve this for the benefit of patients. It is also important that we collect good data about collaborative working and practice growth and monitor the effects on patient experience.”