Continuity counts

Maria is a 42-year-old school bus driver with type 2 diabetes, hypertension and osteoarthritis. She has been on my books since her first pregnancy. Over a decade, we have navigated gestational diabetes, a knee replacement, the loss of her mother and, most recently, persistent fatigue that turned out to be iron-deficiency anaemia. 

Because I know her history (and she knows I remember it), Maria feels safe raising small worries before they become big ones. That longitudinal relationship – common in Australian general practice but too often taken for granted –  is precisely what the new Patient Reported Indicator Surveys (PaRIS) 2025 report has now quantified.

The Organisation for Economic Co-operation and Development (OECD) led PaRIS to provide the first international benchmark of how people with chronic conditions experience primary care. Australia’s inaugural results, released in July 2025, are encouraging: across 10 domains, we sit at or above the OECD average. Yet the most powerful message is about continuity.

According to PaRIS, 97% of patients who had stayed with the same GP for three to five years rated their care as good to excellent, compared to only 79% of those who saw different doctors. The correlation is no surprise to clinicians, but having it measured in patients’ own words gives policymakers fewer excuses to ignore the relational core of general practice.

Continuity also underpins coordination. Of the respondents, 74% reported positive experiences of care coordination – well above the OECD average of 59%. Australia’s position in the top five for this measure reflects the invisible work GPs do every day: reconciling medication lists, translating hospital discharge letters, and constantly ‘chasing’ missing imaging reports. When that work is fragmented across multiple providers, errors creep in and patients disengage.

Quality perceptions follow the same pattern. Ninety-four per cent of patients rated the overall quality of their GP care as good to excellent, again placing Australia among the top performers internationally. 

Crucially, trust is entwined with both quality and continuity: PaRIS found that 87% of patients who had an ongoing GP relationship trusted their doctor, versus 77% among those without such continuity. 

Trust, coordination and quality form a cycle that delivers better physical, mental and social outcomes – especially for people juggling multiple chronic illnesses.

So what now? First, funding levers must reward relational care, not just transactional throughput. PaRIS reminds us that continuity is not an old-fashioned luxury – it is a measurable determinant of health. 

When Maria left last week with her iron tablets, having had a discussion around the causes of iron deficiency and a follow-up appointment for review, she said, “I knew you’d figure it out.” That confidence is the quiet engine of better outcomes. 

The challenge for policymakers is to make sure every Australian patient, GP and general practice, can say the same for our future.