RT Journal Article
SR Electronic
T1 OpenSAFELY NHS Service Restoration Observatory 1: primary care clinical activity in England during the first wave of COVID-19
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP BJGP.2021.0380
DO 10.3399/BJGP.2021.0380
A1 Helen J Curtis
A1 Brian MacKenna
A1 Richard Croker
A1 Peter Inglesby
A1 Alex J Walker
A1 Jessica Morley
A1 Amir Mehrkar
A1 Caroline E Morton
A1 Seb Bacon
A1 George Hickman
A1 Chris Bates
A1 David Evans
A1 Tom Ward
A1 Jonathan Cockburn
A1 Simon Davy
A1 Krishnan Bhaskaran
A1 Anna Schultze
A1 Christopher T Rentsch
A1 Elizabeth J Williamson
A1 William J Hulme
A1 Helen I McDonald
A1 Laurie Tomlinson
A1 Rohini Mathur
A1 Henry Drysdale
A1 Rosalind M Eggo
A1 Kevin Wing
A1 Angel YS Wong
A1 Harriet Forbes
A1 John Parry
A1 Frank Hester
A1 Sam Harper
A1 Stephen JW Evans
A1 Ian J Douglas
A1 Liam Smeeth
A1 Ben Goldacre
A1 (The OpenSAFELY Collaborative)
YR 2021
UL http://bjgp.org/content/early/2021/11/08/BJGP.2021.0380.abstract
AB Background The COVID-19 pandemic has disrupted healthcare activity. 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 the volume and variation of coded clinical activity in general practice, taking respiratory disease and laboratory procedures as examples.Design and setting Working on behalf of NHS England, a cohort study was conducted of 23.8 million patient records in general practice, in situ using OpenSAFELY.Method Activity using Clinical Terms Version 3 codes and keyword searches from January 2019 to September 2020 are described.Results Activity recorded in general practice declined during the pandemic, but largely recovered by September. There was a large drop in coded activity for laboratory tests, with broad recovery to pre-pandemic levels by September. One exception was the international normalised ratio test, with a smaller reduction (median tests per 1000 patients in 2020: February 8.0; April 6.2; September 6.9). The pattern of recording for respiratory symptoms was less affected, following an expected seasonal pattern and classified as ‘no change’. Respiratory infections exhibited a sustained drop, not returning to pre-pandemic levels by September. Asthma reviews experienced a small drop but recovered, whereas chronic obstructive pulmonary disease reviews remained below baseline.Conclusion An open-source software framework was delivered to describe trends and variation in clinical activity across an unprecedented scale of primary care data. The COVD-19 pandemic led to a substantial change in healthcare activity. Most laboratory tests showed substantial reduction, largely recovering to near-normal levels by September, with some important tests less affected and recording of respiratory disease codes was mixed.