Keywords: Continuity of care, general practice, workforce turnover, handover, primary care, family physicians, healthcare transition

Background:

The ongoing restructuring of healthcare systems, aging of the primary care workforce, and increasing professional mobility are leading to higher turnover rates among family physicians. These transitions can disrupt continuity of care — a core value of general practice — and may negatively affect clinical outcomes, patient satisfaction, and care coordination. Despite its relevance, structured handover protocols in general practice remain poorly implemented and under-researched.

Research questions:

- What are the current practices and perceived challenges related to patient handovers during physician turnover in general practice?
- Can a structured handover protocol improve perceived continuity and patient safety during transitions between family physicians?
- How do patients experience care continuity during these transitional phases?

Method:

We propose a mixed-methods study with three phases:
1 - Quantitative Phase: Cross-sectional survey among general practitioners (GPs) and practice managers in multiple European countries to assess handover practices, tools used, and perceived impact on continuity and safety.
2 - Qualitative Phase: Semi-structured interviews with patients who recently experienced a change of family physician, exploring emotional, relational, and clinical aspects of continuity.
3 - Pilot Intervention: Implementation of a structured handover template in a sample of practices, followed by evaluation using pre-post patient satisfaction surveys and GP feedback.

Results:

Preliminary results are expected to identify:
- Gaps in existing handover practices;
- Variability between countries and practice settings;
- Key elements that patients associate with preserved continuity.
Initial feedback from the pilot will inform feasibility and perceived usefulness of the handover tool.

Conclusions:

Structured handover protocols represent a promising, low-cost strategy to maintain continuity of care during physician transitions. They can be easily integrated into existing electronic health records and foster a safer, patient-centered primary care environment — especially relevant for younger physicians entering increasingly fluid healthcare systems.

Points for discussion:

Should structured handovers become a standard of care in general practice, especially in group practices or residency-based models?

What are the barriers (cultural, organizational, technological) to the implementation of such protocols across Europe?

Could this approach support intergenerational collaboration among family physicians?