The COVID-19 pandemic has produced the biggest change in consultation patterns in British general practice for at least 200 years. The St Leonard’s Practice in Exeter has for years recorded and analysed consultation data.1,2
After NHS guidance to reduce face-to-face consultations, there was an immediate reduction. During March the number of face-to-face consultations fell from a mean of 52.1 (95% confidence interval [CI] = 35.2 to 67.1) per weekday in the 2 weeks before the change to a mean of 3.9 (95% CI = 1.9 to 5.9) for the second half of the month, that is, a 92.5% decrease (P<0.001). The number of telephone consultations increased on average by 85.6% (P = 0.0013) in the same time period, with a mean of 50.1 (95% CI = 40.7 to 57.5) per weekday in the first two weeks of March to a mean of 93.0 (95% CI = 70.5 to 115.5) in the final weeks of the month.
We have produced a table showing appointments per 100 patients by patient age group, before and after (Table 1).
Table 1.
Consultations per 100 registered patient by patient age group and consultation type before and after instigation of lockdown
| Consultations per 100 registered patients | ||||||
|---|---|---|---|---|---|---|
| Age group, years | 1–14 March 2020 | 16–31 March 2020 | ||||
| Face-to-face | Telephone | eConsult | Face-to-face | Telephone | eConsult | |
| 0–19 | 4.11 | 4.66 | 0 | 0.49 | 6.53 | 1.65 |
| 20–64 | 2.28 | 2.07 | 0 | 0.39 | 12.01 | 3.66 |
| ≥65 | 9.35 | 6.49 | 0 | 0.97 | 18.51 | 1.23 |
The practice also began using eConsults and the use of these by age groups is shown on the right-hand side of the table with proportionately more use of eConsults by patients aged <65.
Patients in the lowest two national deciles of the Index of Multiple Deprivation numbered 1324 (14% of the list) and their consultations formed 17.2% of all consultations in the first half of the month and 16.8% afterwards, showing no significant difference (P = 0.8).
This big reduction in face-to-face consultations as a result of the pandemic will have occurred in many other practices. We hope this quantification will assist future planning.
REFERENCES
- 1.Pereira Gray DJ. The key to personal care. J R Coll Gen Pract. 1979;29(208):666–678. [PMC free article] [PubMed] [Google Scholar]
- 2.Sidaway-Lee K, Pereira Gray D, Evans P. A method for measuring of continuity of care in day-today general practice: a quantitative analysis of appointment data. Br J Gen Pract. 2019 doi: 10.3399/bjgp19X701813. [DOI] [PMC free article] [PubMed]