CORE group: Continuity of Care Research at Exeter
Relational continuity is an ongoing interpersonal and therapeutic relationship between a specific clinician and a patient built up over time. It has been described as a ‘cornerstone of general practice’.
Continuity of care matters. There is good evidence that continuity of care results in better patient and clinician outcomes. But, despite these positive outcomes, continuity is declining in UK general practice.
Exeter has a strong history of research on continuity of care especially with our links with St Leonard’s Research Practice. The CORE group is running different projects focussing on continuity of care.
Read on for more information about the CORE group research projects.
Research projects
RE-CONNECT
Re-CONNECT is a project led by Dr Nada Khan, and funded by the Wellcome Trust, to conduct a realist evaluation of continuity of care in general practice. This study will look at practices with high levels of continuity of care, and conduct in-depth ethnographic work and realist interviews to try and understand some of the contextual factors and mechanisms leading to good continuity of care. The project launched in May 2025, and will help inform general practice service development and policy to inform how key enables of continuity of care can be transferred to other practices.
Pharm-CONNECT
Pharm-CONNECT is a project led by Dr Nada Khan, and aims to look at continuity of care in general practice multi-disciplinary teams and to understanding the impact of pharmacy roles on relational and informational continuity. This project is taking a qualitative approach to understand the views of GPs, pharmacy roles and patients. We also plan to develop new ways to measure continuity of care across the general practice multi-disciplinary team using a consensus group method.
This project has been funded by the NIHR School for Primary Care Research.
BRIDGE” (Building an understanding of Relational continuIty Interventions Delivered in General PracticE)
This realist synthesis, led by Dr. Serge Engamba and being undertaken as part of a NIHR School for Primary Care Research (SPCR) fellowship, investigates the mechanisms through which various interventions enhance relational continuity in general practice. The review synthesizes diverse evidence to develop effective delivery strategies, aiming to improve patient outcomes and care experiences through targeted interventions.
PACT Continuity of Care Project
This study, led by Dr. Molly Dineen (Bristol University), Dr. Serge Engamba, and the Primary Care Academic Collaborative Team (PACT), aims to measure the level of continuity of care across UK GP practices and investigates practice factors associated with high and low levels of continuity . By using the Usual Provider of Care Index, the study aims to understand how different access models affect continuity and to explore staff perceptions of the importance of continuity in relation to the care delivered.
Developing Continuity of Care Prediction Models Using Explainable AI
This PhD project, led by Varun Kulkarni under the supervision of Prof. Umesh Kadam and funded by the Exeter Biomedical Research Centre, aims to utilize AI and machine learning to develop predictive models that enhance care outcomes for patients with chronic diseases by incorporating new measures of continuity of care. The project involves the creation and validation of models that predict patient outcomes, thereby facilitating better healthcare planning and management.
Meet the team
The CORE group is led by Dr. Serge Engamba, a GP an NIHR PCCCP research fellow and Dr. Nada Khan, a GP and NIHR Clinical Lecturer within APEx. It also includes renowned colleagues such as: Dr Jane Smith, Professor Phil Evans and Professor Umesh Kadam
They are supported by the practical insights of Dr. Kate Sidaway-Lee and Prof. Denis Pereira Grey from St Leonard’s Research Practice. This team is working to solidify its presence within the local research infrastructure, promoting collaboration within APEx and across the region with academics, clinicians, patients, and policymakers.
SAPC Continuity of care SIG
The Society for Academic Primary Care (SAPC) hosts a Special Interest Group (SIG) on Continuity of Care, which plays a critical role in the broader landscape of general practice and was established by CORE. This group is dedicated to exploring the multifaceted concept of continuity, which includes relational, informational, and episodic continuity, as well as the distributed work across multidisciplinary teams. The main objectives of this SIG are to gather UK primary care researchers to discuss various conceptualizations of continuity of care, foster the development of collaborative projects, share and critique current research, and enhance the dissemination of research findings within the SAPC community and beyond. The group aims to support both established and early career researchers, promoting a dynamic environment for idea generation and future grant applications
For more details, you can visit the SAPC Special Interest Group on Continuity of Care page.
