Collaboration for Academic Primary Care (APEx) Blog
Collaboration for Academic Primary Care (APEx) Blog
Posted by ma403
13 May 2025Authors: Serge Engamba, Nada Khan, Jane Smith
Continuity of care is fundamental in medicine, especially in general practice. It involves the enduring engagement between a patient and their healthcare provider beyond specific episodes of illness, fostering a deep understanding, building trust, and enabling personalized healthcare. This continuity is crucial for improving health outcomes, enhancing patient satisfaction, and increasing the efficiency of healthcare delivery. It is also recognized by policymakers as essential, evidenced by its recent inclusion in the 2025 GP contracts in England and Wales.
At the University of Exeter’s APEX Collaboration for Academic Primary Care (APEx), we are excited to introduce the CORE group (Continuity Of care Research at Exeter ). This dynamic and fast-growing team of academics is dedicated to advancing person-centered care through in-depth continuity of care research. CORE champions relational continuity research both locally and nationally, developing innovative ideas and fostering both new and existing collaborations across all APEX core research themes. the CORE group sits within the “Primary care delivery” theme but would also be relevant to the other themes which are Cancer diagnosis, Mental Health, Long-term conditions and Rehabilitation. These themes include Primary Care Focused Health Services Research, Ageing, Frailty, and Multimorbidity, Early Cancer Diagnosis, Primary Care Mental Health, Public Patient Involvement, and Global Health in a Broader Context.
Mission and Objectives
CORE’s mission is to embed continuity of care as a pervasive theme across all of APEx’s research efforts. By concentrating on this critical healthcare aspect, CORE strives to reveal how enduring healthcare relationships can enhance health outcomes and system efficiency across various medical and social contexts.
Our Team of Experts
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, Prof. Phil Evans, and Prof. 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.
Current Research and Collaborations
Our current projects involve exploratory studies and programmes of work assessing the effects of continuity of care on various health outcomes. These include:
• 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.
• RE-CONNECT: Realist Evaluation of Continuity of Care in General Practice: Dr. Nada Khan’s project, funded by the Wellcome Trust, explores the factors that contribute to high levels of relational continuity in general practice. The goal is to generate actionable, evidence-based recommendations to inform service development and policies, emphasizing the creation of sustainable healthcare practices that prioritize patient-provider relationships.
• 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.
• Understanding and Measuring Team-Based Continuity of Care in General Practice: Led by Dr. Nada Khan and Dr. Judit Konya and funded by NIHR SPCR, this project seeks to develop a novel measurement tool for team-based continuity of care in general practice, with a particular focus on integrating clinical pharmacists and pharmacy technicians. The aim is to assess and improve continuity within multidisciplinary team settings, providing guidelines for effective practice.
• 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.
Vision for the Future
Our ongoing research initiatives are paving the way for significant contributions to the field. We are dedicated to producing evidence that will integrate continuity of care into standard practice and influence future policy and clinical guidelines .
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.
Join Us in Our Journey
We invite researchers, policymakers, and the public to join us in promoting a more connected, continuous, and patient-centred healthcare model. For more information about our ongoing projects or to get involved with our research, please email s.engamba@exeter.ac.uk
