Frontstage continuity is face to face care with the same person. In practice face to face involves a team, but the patient should have a co-ordinator who knows the patient over time. It is possible to provide frontstage continuity over time if one person is there for the crucial moments of care or able to step in when these arise. Other members of the team may handle acute minor illness. When a serious illness arises then the lead can take over.
Backstage continuity, is seamless access to the medical records and access to results. It is also a collective understanding and shared knowledge of the healthcare team looking after that person. Backstage continuity requires a commitment by all the team to provide full and up to date records of every consultation. This is underpinned by an IT system that integrates care and records.
Adam presents to his general practitioner with a tender abdomen on the right side. It has been present for a few weeks. He is seen as an emergency without any records and given advice about gastroenteritis.
He books with his usual GP because he still has symptoms. His GP knows Adam is rarely concerned about his health so is more careful to check. He recalls he diagnosed him with a skin problem in the past. He checks the records and confirms he had excision of a melanoma several years earlier. As a result of his past consultations with Adam (frontstage continuity) supported by the records (backstage continuity) he is able to rapidly diagnose the liver cancer and arrange earlier treatment.
All cases are aggregated and names fictional