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Continuity of care is a core principle of primary care related to improved patient outcomes and reduced healthcare costs. Evidence suggests continuity of care in England is declining. To confirm reports of declining continuity of care, explore differences in decline according to practice characteristics, and examine associations between practice populations or appointment provision and changes in continuity of care. Longitudinal design on GP Patient Survey data reported annually in June or July from 2012 to 2017, whereby the unit of anal