Key points

  • In total, 31 million fewer primary care appointments were booked between April 2020 and March 2021 compared to the previous 12 months – a fall from 310 million to 279 million.

  • London had the lowest drop in total number of appointments, with North East and Yorkshire, East of England and Midlands all seeing a drop in appointments twice as big percentage wise.

  • The way that appointments take place has also shifted. March 2021 saw the highest ever number of telephone appointments in general practice; 11.4 million compared to 6.6 million in March 2020 and 3.5 million in March 2019. Between April 2020 and March 2021, 54% of appointments were face-to-face, compared with 79% in the previous year.

Introduction

Since the start of the pandemic the impact of COVID-19 on primary care, and those working within it, has been significant. Staff have been under considerable pressure to maintain services despite social distancing measures, adjusting to virtual consultations and helping to roll out the COVID-19 vaccine. 

In April and May of 2020 – the first months of the UKs first lockdown – the number of appointments booked in general practice plummeted. This led to concerns about unmet need, particularly for people with long-term health conditions, and the potential for delayed diagnoses. However, consultation numbers recovered fast – and by September 2020 total consultations in general practice had recovered to pre-pandemic levels. 

Here we present three charts which explore the impact of the pandemic on primary care in more detail. The charts cover regional trends in the number of primary care appointments, trends in the number of primary care appointments with GPs and the shifting balance between face-to-face and phone appointments.

1. In total, 31 million fewer primary care appointments were booked between April 2020 and March 2021 compared to the previous year, with the greatest fall in the Midlands

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  • In total, 31 million* fewer primary care appointments were booked between April 2020 and March 2021 compared to the previous 12 months – a fall from 310 million to 279 million.   
  • The fall in primary care appointments was most pronounced in April and May 2020. These months account for 16 million of the 31 million fewer appointments.  
  • The largest fall in primary care appointments was in the Midlands with a 10% drop between April 2020 and March 2021 compared to the previous 12 months – this represents 5.6 million fewer appointments. 

*Note: The total figure of 31 million is based on NHS Digital estimated total appointments, which is an estimated total if all practices that submitted data (a small percentage don’t submit or submit late). The region level data in the table shows the actual numbers for those practices that submitted data.

2. By September 2020 total consultations in general practice had recovered to pre-pandemic levels and March 2021 saw the total number of appointments exceed those seen in March 2019 and the highest recorded number of appointments with a GP

  • 28.5 million primary care appointments took place in March 2021 – nearly 4 million more than March 2020 and 2 million more than March 2019.

  • In March 2021 there were 14.7 million appointments with a GP. This compares with 12.8 million in March 2020 and 13.6 million in March 2019, and is the highest number of appointments with GPs per month since records began in November 2017.

  • Pre-pandemic, general practice in England was struggling with increasing workload and longstanding workforce shortages. Under-met need during COVID lockdowns, new illness (including mental ill health) resulting from the pandemic, and record hospital waiting lists are all likely to increase pressure on general practice further in the months ahead.

3. The way that appointments take place has shifted, with the highest ever number of telephone appointments taking place in March 2021

  • 15.8 million face to face appointments took place in March 2021 –  similar to March 2020, but nearly 5 million fewer than March 2019.  
  • March 2021 saw the highest ever number of telephone appointments with 11.4 million compared to 6.6 million in March 2020 and 3.5 million in March 2019. 
  • The switch to telephone consulting was a necessary response to the need to reduce COVID spread. It required significant agility from general practice teams. Further agility will be required to evolve the blend of face-to-face and telephone appointments to meet patient needs and adapt to ever-changing circumstances.

Further reading

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