Accelerating my career in general practice research and policy: a realist evaluation of relational continuity in UK general practice

Patients in the UK are losing the thread of seeing the same GP over time, and this project aims to figure out why efforts to restore that connection work in some practices but fail in others. Continuity of care—where a patient sees the same doctor repeatedly—has been declining in UK general practice for years. Research shows it improves patient trust, reduces hospital admissions, and lowers costs. Yet attempts to boost continuity often produce inconsistent results. This project uses a method called realist evaluation to dig into the mechanics: what specific conditions, staff behaviours, or organisational setups make continuity interventions stick? The researcher will interview practice staff and test an initial theory, then refine it into a practical framework that explains what works, for whom, and under what circumstances. If successful, the research will produce transferable insights that other GP practices can use to design better continuity strategies. The project also includes a policy secondment with a think tank, ensuring that findings directly inform national NHS policy on general practice. The ultimate impact is a more coherent, less fragmented experience for patients—and a clearer roadmap for policymakers trying to fix a system that quietly affects nearly everyone in the UK.