Was access to video consultations with GPs in England equitable during the early COVID-19 lockdown period?

Abstract

The COVID-19 pandemic compelled clinicians to change access to primary health care as face-to-face consultations were a risk to patients and staff. Video consultations (VCs) were frequently substituted as a proxy for a clinical examination. We were interested in finding out whether people from lower socioeconomic backgrounds in England had equitable video access to their GPs during the initial COVID-19 lockdown period. There are various VC applications available to GPs. We used publicly available data from one supplier in this study. Data were available for the number of VCs that GP practices from each clinical commissioning group (CCG) in England completed during March 2020. We ranked CCGs and their socioeconomic backgrounds by using Indices of Multiple Deprivation (IMD) data added from GOV.UK resources. In March, there were 77 834 VCs recorded for England, with a range of 4.3 to 45.4 VCs per GP practice per month (interquartile range 13.7-24.3). There was a negative correlation between consultation rate and deprivation (IMD) (Pearson -0.276, P = 0.04), suggesting a nearly 60% difference in VC rate between most and least deprived CCGs, with the least affluent CCGs having fewest VCs. While video use overall was low, patients from lower socioeconomic backgrounds had less access to VCs with their GPs in the initial lockdown, which may have had negative impacts on health. The pandemic was an unprecedented event, and primary care rapidly pivoted to online care. However, to mitigate health inequalities, primary care must implement methods to cater for all patients and minimise the risk of digital health exclusion.