OpenSAFELY NHS Service Restoration Observatory 2: changes in primary care clinical activity in England during the COVID-19 pandemic

The British journal of general practice: the journal of the Royal College of General Practitioners

article

Wasim Baqir¹  Chris Bates²  John Parry²  Ben Goldacre³  Helen J Curtis³  Brian MacKenna³  Milan Wiedemann³  Louis Fisher³  Richard Croker³  Caroline E Morton³  Peter Inglesby³  Alex J Walker³  Jessica Morley³  Amir Mehrkar³  Sebastian CJ Bacon³  George Hickman³  David Evans³  Tom Ward³  Simon Davy³  William J Hulme³  Orla Macdonald³  Robin Conibere⁴  Tom Lewis⁵  Martin Myers⁶  Shamila Wanninayake⁷  Kiren Collison¹  Charles Drury⁸  Miriam Samuel⁹  Harpreet Sood^1,10  Andrea Cipriani^1,11  Seena Fazel^1,11  Manuj Sharma^1,12 

[1] NHS England and NHS Improvement;TPP;The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford;Beacon Medical Group;Royal Devon University Healthcare NHS Foundation Trust;Lancashire Teaching Hospitals NHS Foundation Trust;The Manor Surgery;Herefordshire and Worcestershire Health and Care NHS Trust;Wolfson Institute of Population Health, Queen Mary University of London;University College London Hospitals NHS Foundation Trust;Department of Psychiatry, University of Oxford;Department of Primary Care and Population Health, University College London

关键词: COVID-19;    electronic health records;    general practice;    primary health care;   

DOI  :  10.3399/BJGP.2022.0301

学科分类：卫生学

来源: Royal College of General Practitioners

【 摘 要 】

Background The COVID-19 pandemic has disrupted healthcare activity across a broad range of clinical services. The NHS stopped non-urgent work in March 2020, later recommending services be restored to near-normal levels before winter where possible.Aim To describe changes in the volume and variation of coded clinical activity in general practice across six clinical areas: cardiovascular disease, diabetes, mental health, female and reproductive health, screening and related procedures, and processes related to medication.Design and setting With the approval of NHS England, a cohort study was conducted of 23.8 million patient records in general practice, in situ using OpenSAFELY.Method Common primary care activities were analysed using Clinical Terms Version 3 codes and keyword searches from January 2019 to December 2020, presenting median and deciles of code usage across practices per month.Results Substantial and widespread changes in clinical activity in primary care were identified since the onset of the COVID-19 pandemic, with generally good recovery by December 2020. A few exceptions showed poor recovery and warrant further investigation, such as mental health (for example, for ‘Depression interim review’ the median occurrences across practices in December 2020 was down by 41.6% compared with December 2019).Conclusion Granular NHS general practice data at population-scale can be used to monitor disruptions to healthcare services and guide the development of mitigation strategies. The authors are now developing real-time monitoring dashboards for the key measures identified in this study, as well as further studies using primary care data to monitor and mitigate the indirect health impacts of COVID-19 on the NHS.

【 授权许可】

Free