Investigating disruptions in primary care as a result of the COVID-19 pandemic and the introduction of national lockdowns

Date of Approval
Application Number
Technical Summary

This study aims to describe temporal trends in the provision of primary care in the UK before, during and after the introduction of COVID-19 national lockdowns. Studies have reported a reduction in A&E attendance and admissions at secondary care settings but less is known about the disruptions to care delivered in primary care settings. In this study, our exposure(s) will be the introduction of the national lockdowns. We will utilise an interrupted time series (ITS) framework (with time divided into before, during and between the introduction of national lockdowns and also a longer-term post-lockdown period representing the next phase of the COVID-19 pandemic) and use negative binomial regression models to estimate weekly events (e.g., primary care consultations, referrals to outpatients). We will also assess trends in risk factor control pre and post the start of the pandemic (March 2020); and determine the association between both risk factor control and medium to long-term outcomes, primarily cardiovascular events, mortality, and hospital admission.
We will also assess whether the disruption in the provision of primary care has been equitable across different population subgroups, e.g., across different age, ethnic and deprivation groups.

Health Outcomes to be Measured

Weekly consultation counts; consultation type; consultation duration; referrals to outpatient services; incidence of first diagnoses of cardio-metabolic conditions; indicators of risk factor control (e.g. blood pressure, lipids, HbA1c, BMI, medication adherence (medication possession rate) and smoking status); medium to long-term outcomes (cardiovascular events, mortality, and hospital admission).


Kamlesh Khunti - Chief Investigator - University of Leicester
Tom Norris - Corresponding Applicant - University of Leicester
Claire Lawson - Collaborator - University of Leicester
Clare Gillies - Collaborator - University of Leicester
Francesco Zaccardi - Collaborator - University of Leicester
Samuel Seidu - Collaborator - Leicester Diabetes Centre


HES Admitted Patient Care;ONS Death Registration Data;Patient Level Index of Multiple Deprivation