Paper Summary: How did childrens’ contacts with GPs change during COVID-19?
Research commissioned by NIHR ARC NWL and led by Dr Kim Foley found a two-fold rise in remote consulting during lockdowns mitigated falls in childrens’ face-to-face GP contacts.
Overview of findings
Children and young people’s contacts with general practitioners (GPs) in England dropped by 41%, during the first COVID-19 lockdown from March to June 2020 compared with previous years. Although the stay-at-home advice meant that face-to-face contacts with those aged 0 to 24 years fell by 88%, a more than twofold increase in telephone, video or online (remote) contacts enabled GPs to provide first contact care throughout the pandemic period. Remote contacts increased most for infants, who prior to the pandemic would see a GP 3 to 6 times per year.
Researchers at Imperial College London funded by the National Institute for Health and Care Research examined 47,607,765 electronic health records collected from GP practices in England from over 4 million children and young people from 2015 to 2020. They studied the impact of the first COVID-19 lockdown on total, face-to-face, and remote contacts with children and young people aged 0 to 24. Children aged 1-14 years had greater falls in overall contacts with GPs compared with infants and those aged 15-24 years.
There were large falls in contacts with GPs for respiratory illnesses, which is partially explained by children getting fewer viral infections. In contrast, for conditions such as diabetes or urinary tract infections, which were less affected by the lockdown, GP contacts had lesser overall falls (although there was a large shift from face-to-face to remote). Despite the challenges of the pandemic, these findings indicate that GPs largely continued to provide accessible acute care for children and young people.
Comments
“Our study shows a huge shift to remote contacts during the first COVID-19 lockdown that mitigated the overall falls in children’s contacts with GPs. Moving forward, more research is needed to determine the optimal combination between face-to-face and remote contacts and it is important to consider the preferences of children and families.”
Dr Kim Foley, from the Department of Primary Care and Public Health at Imperial College London, and the first author on this study.
“It is reassuring to see that the efforts of hard-working GPs across the country helped children to see their GP safely across the first lockdown period while observing the government safety advice not to attend in person. Our study shows lockdown measures resulted in fewer contacts for respiratory illnesses but with a lift in restrictions, infections are again on the rise and families need our support to keep children healthy in the community. Practices need much more investment staff and resources to cope with the added workload that we were already struggling with even before the pandemic."
Professor Sonia Saxena, from the Department of Primary Care and Public Health at Imperial College London, a practising GP, and senior author on this study.
The research was commissioned by the National Institute for Health and Care Research (NIHR) under the Applied Health Research (ARC) programme for Northwest London and supported by the NIHR Policy Research Programme COVID-19 research.
Further reading
Read the paper in The British Journal of General Practice in full: https://bjgp.org/content/early/2022/04/04/BJGP.2021.0643
Read the blog describing the work Kim did gathering the perspectives of parents/carers about children’s healthcare experiences during COVID-19: https://blogs.imperial.ac.uk/perc/2022/02/07/involving-parents-and-carers-in-research-about-childrens-healthcare-experiences-during-covid-19/
Lockdown reduced children’s contacts with GPs but increased remote appointments (Imperial College website): https://www.imperial.ac.uk/news/235118/lockdown-reduced-childrens-contacts-with-gps/
More from BJGP
Listen to Dr Kim Foley in conversation with BJGP Editor Euan Lawson as they discuss the findings from this paper.
