The aim of the study is to explore how the use of primary care at the population level has changed since January 2019 until present day (covering the course of the COVID-19 pandemic) and how this varies by age, sex, ethnicity, region, rural-urban classification, pre-existing condition and deprivation. In particular, this study will focus on changes in consultation rate, consultation mode, new and repeat prescriptions issued, referrals and immunisations. This study will build upon previous studies (in particular, work undertaken by the Health Foundation in 2020-21) which have found that there were dramatic shifts in service use in the early months of the COVID-19 pandemic including a large initial drop in activity in March 2020 followed by a steady recovery (though with some sub-group variation). This study will replicate some of this analysis but seeks to update it to encompass more recent developments (from May 2021 onwards) to understand how trends have changed following the removal of all pandemic-related restrictions and expand it to consider variations by deprivation and rural-urban classification. An understanding of the changing demand on primary care use in response to the COVID-19 pandemic will inform policy on how best for the NHS and primary care sector to recover.
The aim of the study is to build on previous work undertaken by the Health Foundation in 2020-21 to reproduce and update summary statistics on the use of primary care at a high level, and broken down by demographic subgroups (including age band, sex, ethnic group, region, urban/rural classification and deprivation) to explore changes in demand for primary care activity over time. In particular, we will examine:
Changes in consultation rates over time, both overall rates and broken down by sub-groups, including for patients with pre-existing long-term conditions – this will be based on diagnosis codes from the patient’s historical data.
Changes in mode of consultation over time (remote vs face to face)
Exploratory analysis of trends in diagnoses arising from consultations to understand conditions driving demand for primary care.
Changes in outcomes of consultations (referrals, prescribing, tests, immunisation) over time
Our analysis will be based on a random sample of 500,000 of all research acceptable patients registered for at least one day in CPRD Aurum between 01/01/2016 and present day. We will present the weekly rates of primary care activity for different groups from 2019 onwards. In order to take account of observed seasonality in primary care use, we will also look at the percentage change in weekly consultation rates in 2021/2022 compared with the average weekly consultation rates between 2016–20.
An understanding of the changing demand on primary care use will inform policy on how best for the NHS and primary care sector to recover.
Primary care consultation rates, mode of consultation, new and repeat prescriptions issued, referrals and immunisations.
Key patient groups include breakdowns by age band; sex; ethnicity; region; rural/urban classification; pre-existing long-term condition (Cancer, Diabetes, Heart Failure, Coronary Heart Disease, Atrial Fibrillation, Asthma, Chronic Obstructive Pulmonary Disorder, Stroke, Chronic Kidney Disease, Chronic Liver Disease, Depression, Anxiety, Dementia).
Caroline Hough - Chief Investigator - Office for Health Improvement and Disparities
Caroline Hough - Corresponding Applicant - Office for Health Improvement and Disparities
Daniel Phillips - Collaborator - Office for Health Improvement and Disparities
Thomas Darwent - Collaborator - Office for Health Improvement and Disparities
Patient Level Index of Multiple Deprivation;Practice Level Rural-Urban Classification