Impact of the COVID-19 pandemic on cancer assessment in primary care: a qualitative study of GP views

Archer, Stephanie; Calanzani, Natália; Honey, Stephanie; Johnson, Margaret; Neal, Richard D; Scott, Suzanne E.; Walter, Fiona M

doi:10.3399/bjgpo.2021.0056

Cited by 20 publications

(24 citation statements)

References 24 publications

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“…In a qualitative interview study of GPs in the Flemish part of Belgium to gain insights into the consequences of the COVID-19 outbreak on the core functions of primary care, there was a major switch towards telephone triage and consult, there was a feeling that acute care was compromised, chronic care was mostly postponed and there was a worry about continuity of regular care [ 17 ]. Though there is some data on healthcare professional views on the impact of the COVID-19 pandemic on healthcare services such as cancer care management, arthroplasty services, and routine care for chronic diseases [ 11 , 15 , 18 , 19 ], there is limited data for primary care diabetes services specifically. Our study provides a previously unreported comprehensive assessment of the perspectives of healthcare professionals regarding the impact of the COVID-19 pandemic on the delivery of primary care for diabetes in UK primary care.…”

Section: Discussionmentioning

confidence: 99%

“…Despite emerging evidence on the impact of the COVID pandemic on primary care services [ [15] , [16] , [17] ], the impact on primary care diabetes services specifically is uncertain. In this context, using an online survey developed by primary care diabetes experts, our primary objective was to examine the impact of the COVID pandemic on primary care diabetes services in the UK from a healthcare professional perspective.…”

Section: Aimmentioning

confidence: 99%

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The impact of the COVID pandemic on primary care diabetes services in the UK: A cross-sectional national survey of views of health professionals delivering diabetes care

Seidu

Hambling²,

Holmes³

et al. 2022

Primary Care Diabetes

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Background Healthcare systems worldwide have been adversely affected by the Coronavirus disease 2019 (COVID-19) pandemic. There has been a substantial decrease in admissions for acute medical conditions with longer delays between the onset of the symptoms and hospital treatment compared to the pre-pandemic period. The impact of the COVID pandemic on primary care services is uncertain. Aim Using an online survey, we examined the impact of the COVID pandemic on primary care diabetes services in the UK. Methods An online survey was developed by the Primary Care Diabetes Society research group and administered to healthcare and allied health professionals delivering diabetes care in the UK from January to May 2021. Descriptive statistics and odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. Results Of the 1070 professionals surveyed, 975 (91.1%) completed the questionnaire. Most respondents were nurses or nurse practitioners (59.7%) and doctors (32.9%). The mean age of respondents was 52 years and 79% were female. The majority of respondents felt overloaded with work (71.2%) or emotionally drained at the end of a working day (79.1%) compared with the pre-pandemic period. Being a doctor and worried about infecting a family member with the Coronavirus were each associated with an increased odds of being substantially overworked or emotionally drained: (OR = 2.52; 95% CI, 1.25−5.07) and (OR = 2.05; 95% CI, 1.24–3.39), respectively. The most common consultation method used to provide diabetes care during the pandemic was telephone consultation (92.0%). Overall 79.1% of respondents felt the COVID-19 pandemic had had moderate to significant impact on their practice's ability to provide routine diabetes care; 70.6% of respondents felt the COVID-19 pandemic had had moderate to significant impact on their practice's ability to provide routine health checks or screening for type 2 diabetes and approximately half of respondents (48.3%) reported encountering mental health concerns in people with diabetes. Conclusions COVID-19 pandemic has had significant impact on the ability of healthcare professionals and their practices to deliver routine diabetes care. Failure to restore primary care provision urgently and safely to at least pre-pandemic levels in a sustainable manner may lead to emotionally drained and overworked workforce in primary care, place additional burden on the already overburdened healthcare system and worse outcomes for patients.

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Section: Discussionmentioning

confidence: 99%

Section: Aimmentioning

confidence: 99%

The impact of the COVID pandemic on primary care diabetes services in the UK: A cross-sectional national survey of views of health professionals delivering diabetes care

Seidu

Hambling²,

Holmes³

et al. 2022

Primary Care Diabetes

View full text Add to dashboard Cite

show abstract

“… 21 These changes present trade-offs for patients 22 and clinicians, 20 particularly in the context of assessing potential cancer symptoms. 23 Any positive consequences (for example, improved flexibility and reducing COVID-19 infection risk) have to be balanced with ensuring adequate diagnostic assessment 23 and avoiding exacerbation of health inequalities. 24 …”

Section: Introductionmentioning

confidence: 99%

Socioeconomic differences in help seeking for colorectal cancer symptoms during COVID-19: a UK-wide qualitative interview study

Black

Vindrola‐Padros

et al. 2022

Br J Gen Pract

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Background: COVID-19 has led to rapid changes in health care delivery, raising concern that these changes may exacerbate existing inequalities in patient outcomes. Aim: To understand how patients’ help-seeking experiences in primary care for colorectal cancer symptoms during COVID-19 were affected by socioeconomic status (SES). Design & setting: Qualitative semi-structured interviews with men and women across the UK, recruited using purposive sampling by SES. Method: Interviews were carried out with 39 participants (20 higher SES; 19 lower SES) who contacted primary care about possible symptoms of colorectal cancer during COVID-19. Data were analysed using framework analysis followed by comparative thematic analysis to explore differences between groups. Results: Three themes were identified with differences between SES groups: (1) How people decided to seek medical help through appraisal of symptoms; (2) How people navigated services; and (3) Impact of COVID-19 on how patients interacted with healthcare professionals. The lower SES group expressed uncertainty appraising symptoms and navigating services (in terms of new processes resulting from covid and worries about infection). There was also potential for increased disparity in diagnosis and management, with other methods of getting in touch (e.g., email, 111) taken up more readily by higher SES patients. Conclusion: Our findings suggest that COVID-19 exacerbated disparities between higher and lower SES participants. This study raises awareness around challenges in help-seeking in the context of the pandemic which are likely to persist (post-COVID) as healthcare systems settle on new models (e.g., digital) of care. Recommendations are provided to reduce inequalities of care.

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“…The coronavirus disease (COVID-19) pandemic had led to an abrupt transformation in healthcare systems [1,2]. There was an urgent need for rapid modification and expansion of hospital ward structures [3,4], mobilisation of healthcare professionals, and reorganisation of medical and surgical provisions [5,6].…”

Section: Introductionmentioning

confidence: 99%

Does the length of stay in hospital affect healthcare outcomes of patients without COVID-19 who were admitted during the pandemic? A retrospective monocentric study

et al. 2022

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Uncertainties remain if changes to hospital care during the coronavirus disease (COVID-19) pandemic had an adverse impact on the care-quality of non-COVID-19 patients. We examined the association of hospital length of stay (LOS) with healthcare quality indicators in patients admitted with general medical conditions (non-COVID-19). In this retrospective monocentric study at a National Health Service hospital (Surrey), data were collected from 1st April 2019 to 31st March 2021, including the pandemic from 1st March 2020. Primary admissions, in-hospital mortality, post-discharge readmission and mortality were compared between the pre-pandemic (reference group) and pandemic period, according to LOS categories. There were 10,173 (47.7% men) from the pre-pandemic and 11,019 (47.5% men) from the pandemic period; mean (SD) age 68.3 year (20.0) and 68.3 year (19.6), respectively. During the pandemic, primary admission rates for acute cardiac conditions, pulmonary embolism, cerebrovascular accident and malignancy were higher, whilst admission rates for respiratory diseases and common age-related infections, and in-hospital mortality rates were lower. Amongst 19,721 survivors, sex distribution and underlying health status did not significantly differ between admissions before the pandemic and during wave-1 and wave-2 of the pandemic. Readmission rates did not differ between pre-pandemic and pandemic groups within the LOS categories of < 7 and 7–14 days, but were lower for the pandemic group who stayed > 14 days. For patients who died within seven days of admission, in-hospital mortality rates were lower in patients admitted during the pandemic. Mortality rates within 30 days of discharge did not differ between pre-pandemic and pandemic groups, irrespective of the initial hospital LOS. Despite higher rates of admission for serious conditions during the pandemic, in-hospital mortality was lower. Discharge time was similar to that for patients admitted before the pandemic, except it was earlier during the pandemic for those who stayed > 14 days, There were no group differences in quality-care outcomes.

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Impact of the COVID-19 pandemic on cancer assessment in primary care: a qualitative study of GP views

Cited by 20 publications

References 24 publications

The impact of the COVID pandemic on primary care diabetes services in the UK: A cross-sectional national survey of views of health professionals delivering diabetes care

The impact of the COVID pandemic on primary care diabetes services in the UK: A cross-sectional national survey of views of health professionals delivering diabetes care

Socioeconomic differences in help seeking for colorectal cancer symptoms during COVID-19: a UK-wide qualitative interview study

Does the length of stay in hospital affect healthcare outcomes of patients without COVID-19 who were admitted during the pandemic? A retrospective monocentric study

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