Impact of COVID-19 on primary care contacts with children and young people in England: longitudinal trends study 2015–2020

Abstract

Background: The NHS response to covid-19 altered provision and access to primary care. Aim: To examine the impact of covid-19 on general practitioner (GP) contacts with children and young people in England. Design and Setting: Longitudinal trends analysis using electronic health records from the Clinical Practice Research Datalink Aurum database. Methods: We included all children and young people younger than 25 years registered with a GP. We compared the number of total, remote and face-to-face contacts during the first UK lockdown (March to June 2020) with the mean contacts for comparable weeks from 2015 to 2019. Results: We examined 47 607 765 GP contacts with 4 307 120 million children and young people. GP contacts fell 41% during the first lockdown compared with previous years. Children aged 1-14 had greater falls in total contacts (>50%) compared with infants and 15-24s. Face-to-face contacts fell by 88% with the greatest falls occurring among children aged 1-14 (> 90%). Remote contacts more than doubled, increasing most in infants (over 2.5 fold). Total contacts for respiratory illnesses fell by 74% whereas contacts for common non-transmissible conditions shifted largely to remote, mitigating the total fall (31%). Conclusion: During the covid-19 pandemic, children and young people’s contact with GPs fell, particularly for face-to-face assessment. This may be explained by a lower prevalence of respiratory illnesses due to fewer social contacts and changing health care seeking behaviour. The large shift to remote contacts mitigated total falls in contacts for some age groups and for common non-transmissible conditions.

Impact of COVID-19 on outpatient appointments in children and young people in England: an observational study

“…[35][36][37] The fall in CYP outpatient activity reflects changes in need, a decrease in health seeking behaviour and changes in health system pathways, including a move towards remote consultations and redeployment of Paediatric staff to care for COVID-19 patients. Similar changes in activity during this period were seen across the health system, including in primary care 38 and emergency care. 4 39 The extent to which the fall in CYP outpatient activity can be attributed to a decrease in health seeking behaviour is unknown.…”

Consultation rate and mode in English general practice, 2018 to 2022: a population-based study by deprivation

“…These trends in consultation mode have been observed elsewhere but not in a large nationally representative sample. (3,6,7,12,13) The dip in the proportion of face-to-face consultations at the start of the pandemic likely reflects operational guidance at the time. The pandemic created a driver for change.…”

“…However, we found a strong increase in the use of remote consultations during the pandemic, with a peak around 75% of consultations being remote, which is consistent with other sources giving us confidence in our methods. (13)…”

Health Care Resource Utilization and Costs Associated With COVID-19 Among Pediatrics Managed in the Community or Hospital Setting in England: A Population-based Cohort Study

“…45 Data from a longitudinal study assessing the uptake of remote consultations in the UK demonstrated a drop in F2F consultations in all ages since the pandemic due to infection control; however, this reduction was less for patients 0-4 years old than 5-17 years old. 35,46 We observed a higher proportion of primary care consultations in both children at higher risk of severe COVID-19 and in the immunocompromised group than in the overall cohort. We also observed proportionally greater health care resource use in highrisk patients than in those who were immunocompromised, which is in keeping with literature that has shown that in children, being immunocompromised did not increase the risk of severe COVID-19, 47 but that presence of underlying conditions is a key driver of increased risk of severe COVID-19.…”