Public perception of NHS general practice during the first six months of the COVID-19 pandemic in England.

Lorna J Duncan,Kelly F.D Cheng

doi:10.12688/f1000research.52392.1

Abstract

Background:In March 2020, the delivery of NHS general practice consultations was rapidly modified to mitigate against the spread of COVID-19. Remote triage and consultations became the default, with adapted models for face-to-face contact if clinically required. This study aimed to gain insight into public perception of these adaptations. Methods:Two online surveys were developed, and conducted between August and September 2020. Survey A, open to anyone receiving the link to it, considered respondents' experiences of healthcare contacts since March 2020, and their understanding of the adapted delivery. Survey B, open to survey A respondents only, then considered how healthcare communication had been received and individual preferences for this. Survey participation was voluntary. Results:The views and experiences of 150 members of the public were obtained. 105 had considered contacting general practice, although half avoided this or delayed doing so for longer than usual. While some patients did so 'to help the NHS', others experienced reduced access for a variety of reasons including COVID-19 safety concerns. Some however reported benefitting from remote consultation availability and regular texts/emails from their practice. 68% (102/150) of respondents were unaware that patients with COVID-19 were seen separately from other patients during general practice appointments. 27% of those in survey B who had avoided or delayed contact said they would have felt more comfortable contacting general practice had they known about this. Conclusions: Experience and use of the adapted general practice models varied. Some patients felt their access to healthcare was reduced, often due to technological requirements. For some who found attending face-to-face appointments difficult however, remote contact was advantageous. Most patients surveyed were unaware of the COVID-19 control measures in place during face-to-face general practice consultations. Assessment of adapted delivery model accessibility and clearer public messaging about the changes may help reduce inequalities.

Highlights

In March 2020, with the onset of the COVID-19 pandemic, the delivery of general practice consultations changed rapidly and extensively throughout England
National Health Service (NHS) standard operating procedure was adapted to ensure the physical separation of patients with suspected or diagnosed COVID-19 (‘COVID-19 patients’) from others, to minimise cross-infection.[1]
When face-to-face consultations were necessary, they required reorganisation to comply with Infection Prevention and Control (IPC) guidance.[1]

Summary

Introduction

In March 2020, with the onset of the COVID-19 pandemic, the delivery of general practice consultations changed rapidly and extensively throughout England. National Health Service (NHS) standard operating procedure was adapted to ensure the physical separation of patients with suspected or diagnosed COVID-19 (‘COVID-19 patients’) from others, to minimise cross-infection.[1] Remote triage and consultation became the default, with face-to-face contact only used when clinically necessary.[1] As a result, the proportion of face-to-face general practice consultations dropped from 80% before March 2020, to 47% in April 2020. While this rose gradually after the end of the first national lockdown in July, it remained considerably below pre-pandemic levels at 56% in the most recently available (January 2021) data.[2]. Most patients surveyed were unaware of the COVID-19 control measures in place during face-to-face general version 2 (revision)

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