Patient lost in a maze of hospital corridors, representing fragmented healthcare.

The Revolving Door: Why Continuity of Care Matters More Than Ever

Elliot Brynn in Health & Wellness June 2025 • 4 min read.

"Navigating the challenges of fragmented healthcare in the modern NHS."

The National Health Service (NHS), since its inception, has strived to provide comprehensive healthcare to all. Debates about its future often revolve around finances and management, frequently overshadowing the patient's perspective. A stable, consistent approach to medical care is crucial, allowing healthcare professionals to understand the patient's history, build trust, and make well-informed decisions.

However, a growing concern is the lack of continuity of care, where patients encounter a revolving door of different doctors and specialists. This fragmentation undermines the quality of care, erodes patient confidence, and ultimately affects health outcomes. The experience of one physician, detailed in a letter to the BMJ, illustrates this growing problem within the NHS, highlighting the frustrations and potential dangers of a system that prioritizes efficiency over personalized care.

This article examines the importance of continuity of care, dissects the issues contributing to its decline, and offers insights for both patients and healthcare providers on how to navigate and improve the current system.

The Fragmented Reality: Losing the Personal Touch in Healthcare

Patient lost in a maze of hospital corridors, representing fragmented healthcare.

The core issue lies in the increasingly fragmented nature of healthcare. Patients often find themselves shuffled between numerous healthcare professionals, each with limited knowledge of their overall medical history. This is vividly illustrated by the physician's account of being seen by 17 different registrars without a single reassessment by a consultant. Such experiences are not only frustrating but can also lead to critical oversights in treatment and care.

When a patient is constantly seen by different doctors, several negative consequences arise:

Lack of Holistic Understanding: Each new healthcare provider only sees a snapshot of the patient's health, missing the long-term trends and subtle nuances that are crucial for accurate diagnoses and effective treatment.
Erosion of Trust: The constant change in personnel makes it difficult for patients to build trust and rapport with their healthcare providers. This can lead to patients feeling unheard and misunderstood, impacting their willingness to adhere to treatment plans.
Increased Risk of Medical Errors: Without a consistent overview of the patient's medical history, the risk of errors such as conflicting prescriptions or missed allergies significantly increases.
Inefficient Care: Redundant tests and consultations become common as each new doctor requires the patient to repeat their story and undergo similar evaluations, wasting time and resources.

Ultimately, this lack of continuity transforms patients into mere units on a production line, stripping away the personal connection that is vital for effective healthcare. The system's focus on throughput and efficiency often overshadows the need for individualized care, leaving patients feeling disillusioned and underserved.

Rebuilding Continuity: A Path Forward

Restoring continuity of care requires a multi-faceted approach involving healthcare providers, policymakers, and patients themselves. Healthcare systems must prioritize building structures that foster long-term doctor-patient relationships. This includes promoting team-based care models, improving communication and coordination among healthcare professionals, and implementing technology solutions that provide a holistic view of the patient's medical history. By addressing these challenges, we can pave the way for a healthcare system that values both efficiency and personalized care, ultimately leading to better health outcomes and improved patient satisfaction.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1136/bmj.e6039, Alternate LINK

Title: The "Curse Of The Registrar"

Subject: General Engineering

Journal: BMJ

Publisher: BMJ

Authors: J. Walshe

Published: 2012-09-18

Everything You Need To Know

Why is continuity of care considered so important within the National Health Service (NHS)?

Continuity of care is vital in the National Health Service because it enables healthcare professionals to develop a comprehensive understanding of a patient's medical background, fostering trust and facilitating well-informed decision-making. This consistent approach helps in providing personalized care that addresses the specific needs of each patient, leading to better health outcomes. Without it, the NHS risks undermining the quality of care and eroding patient confidence.

What are the primary issues contributing to the decline of continuity of care, particularly in systems like the NHS?

The primary issue is the increasingly fragmented nature of healthcare, where patients are frequently seen by numerous healthcare professionals who each have limited knowledge of their overall medical history. This fragmentation can lead to a lack of holistic understanding, erosion of trust between patients and providers, an increased risk of medical errors due to conflicting information, and inefficient care stemming from redundant tests and consultations. Addressing this requires healthcare systems to build structures that foster long-term doctor-patient relationships.

In what ways does the lack of continuity of care affect patient experiences and health outcomes?

The absence of continuity in care can lead to several negative outcomes for patients. They may feel unheard and misunderstood, impacting their willingness to adhere to treatment plans. The risk of medical errors, such as conflicting prescriptions or missed allergies, increases significantly. Redundant tests and consultations become common, wasting time and resources. Ultimately, this fragmented approach diminishes the personal connection vital for effective healthcare, transforming patients into mere units and leading to dissatisfaction and potentially poorer health outcomes.

What steps can healthcare systems take to rebuild and promote continuity of care for their patients?

To restore continuity of care, healthcare systems must prioritize building structures that foster long-term doctor-patient relationships. This includes promoting team-based care models to ensure a consistent care team, improving communication and coordination among healthcare professionals so that information is shared effectively, and implementing technology solutions that provide a holistic view of the patient's medical history, giving each doctor access to the same data. Prioritizing both efficiency and personalized care will lead to improved patient satisfaction and better health outcomes.

How can patients play an active role in ensuring they receive consistent and continuous healthcare within a fragmented system like the NHS?

While not explicitly detailed, patients can actively participate by maintaining detailed personal medical records, including medications, allergies, and past treatments, and sharing this information with each new healthcare provider they encounter. Patients could advocate for themselves by requesting to see the same doctor or care team whenever possible and by proactively communicating their health history and concerns during consultations. Furthermore, leveraging patient portals and digital health tools to track and share their health information can enhance continuity, though the availability and integration of such tools within systems like the NHS may vary. By taking these steps, patients can help bridge gaps in communication and ensure a more cohesive and informed healthcare experience.