{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T12:51:12Z","timestamp":1789044672939,"version":"build-2803163510"},"reference-count":43,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Public Health Surveill"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The COVID-19 pandemic has had a significant impact on primary care service delivery with an increased use of remote consultations. With general practice delivering record numbers of appointments and rising concerns around access, funding, and staffing in the UK National Health Service, we assessed contemporary trends in consultation rate and modes (ie, face-to-face versus remote).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This paper describes trends in consultation rates in general practice in England for key demographics before and during the COVID-19 pandemic. We explore the use of remote and face-to-face consultations with regard to socioeconomic deprivation to understand the possible effect of changes in consultation modes on health inequalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We did a retrospective analysis of 9,429,919 consultations by general practitioners, nurses, or other health care professionals between March 2018 and February 2022 for patients registered at 397 general practices in England. We used routine electronic health records from Clinical Practice Research Datalink Aurum with linkage to national data sets. Negative binomial models were used to predict consultation rates and modes (ie, remote versus face-to-face) by age, sex, and socioeconomic deprivation over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall consultation rates increased by 15% from 4.92 in 2018-2019 to 5.66 in 2021-2022 with some fluctuation during the start of the COVID-19 pandemic. The breakdown into face-to-face and remote consultations shows that the pandemic precipitated a rapid increase in remote consultations across all groups, but the extent varies by age. Consultation rates increased with increasing levels of deprivation. Socioeconomic differences in consultation rates, adjusted for sex and age, halved during the pandemic (from 0.36 to 0.18, indicating more consultations in the most deprived), effectively narrowing relative differences between deprivation quintiles. This trend remains when stratified by sex, but the difference across deprivation quintiles is smaller for men. The most deprived saw a relatively larger increase in remote and decrease in face-to-face consultation rates compared to the least deprived.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The substantial increases in consultation rates observed in this study imply an increased pressure on general practice. The narrowing of consultation rates between deprivation quintiles is cause for concern, given ample evidence that health needs are greater in more deprived areas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/44944","type":"journal-article","created":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T10:54:06Z","timestamp":1683024846000},"page":"e44944","source":"Crossref","is-referenced-by-count":34,"title":["Consultation Rate and Mode by Deprivation in English General Practice From 2018 to 2022: Population-Based Study"],"prefix":"10.2196","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7284-9172","authenticated-orcid":false,"given":"Emma Maria","family":"Vestesson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4370-2606","authenticated-orcid":false,"given":"Kaat Lieve An","family":"De Corte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8774-224X","authenticated-orcid":false,"given":"Elizabeth","family":"Crellin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2523-7971","authenticated-orcid":false,"given":"Jean","family":"Ledger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6330-4867","authenticated-orcid":false,"given":"Minal","family":"Bakhai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7249-0289","authenticated-orcid":false,"given":"Geraldine M","family":"Clarke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2023,5,2]]},"reference":[{"key":"ref1","unstructured":"The NHS long term planNHS2023-03-13https:\/\/www.longtermplan.nhs.uk\/"},{"key":"ref2","unstructured":"GP ContractNHS20222022-10-15https:\/\/www.england.nhs.uk\/gp\/investment\/gp-contract\/gp-contract-documentation-2018-19\/"},{"key":"ref3","unstructured":"BakhaiMCroneyLWallerOHenshallNFUsing online consultations in primary care implementation toolkitNHS England20202023-04-17https:\/\/www.england.nhs.uk\/publication\/using-online-consultations-in-primary-care-implementation-toolkit\/"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp20X709937"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2020.0948"},{"key":"ref6","unstructured":"VelasquezDMehrotraAEnsuring the growth of telehealth during COVID-19 does not exacerbate disparities in careHealth Affairs Blog20202023-04-13https:\/\/www.healthaffairs.org\/do\/10.1377\/forefront.20200505.591306\/full\/"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3399\/BJGPO.2021.0066"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.3399\/BJGPO.2021.0040"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2021.0596"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp20X710933"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1089\/pop.2020.0186"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1111\/1468-0009.12509"},{"key":"ref13","unstructured":"CPRD Aurum May 2022 datasetCPRD20222022-11-15https:\/\/cprd.com\/cprd-aurum-may-2022-dataset"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz034"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-059374"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.3310\/hsdr05250"},{"key":"ref17","unstructured":"The R Project for Statistical Computing20032022-10-26https:\/\/www.r-project.org\/"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.21105\/joss.00772"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/s1473-3099(12)70315-8"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/S2589-7500(21)00279-X"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2021.0643"},{"key":"ref22","unstructured":"GeraldineCDiasAWoltersAAccess to and delivery of general practice servicesThe Health Foundation20222023-04-13https:\/\/www.health.org.uk\/publications\/access-to-and-delivery-of-general-practice-services"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/978-3-030-82696-3_12","author":"Ledger, J","year":"2021","journal-title":"Organising Care in a Time of Covid-19: Implications for Leadership, Governance and Policy"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.2196\/19375"},{"key":"ref25","unstructured":"BrownJCoronavirus: a history of English lockdown lawsHouse of Commons Library2021-05-09https:\/\/commonslibrary.parliament.uk\/research-briefings\/cbp-9068\/"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.3399\/bjgpo.2021.0036"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2020.1051"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-5890.2016.12109"},{"key":"ref29","unstructured":"Level or not?The Health Foundation2020092022-11-15https:\/\/www.health.org.uk\/publications\/reports\/level-or-not"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.2196\/22581"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-09727-w"},{"key":"ref32","unstructured":"Francis-DevineBPoverty in the UK: statisticsHouse of Commons Library202305062022-11-15https:\/\/researchbriefings.files.parliament.uk\/documents\/SN07096\/SN07096.pdf"},{"key":"ref33","unstructured":"Public perceptions of health and social care (November\u2013December 2021)The Health Foundation20222022-10-27https:\/\/www.health.org.uk\/publications\/public-perceptions-of-health-and-social-care-november-december-2021"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.2196\/21726"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00949-1"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.7861\/fhj.2020-0096"},{"key":"ref37","unstructured":"Ethnic minority-led GP practices: impact and experience of CQC regulationCQC2022-07-18https:\/\/www.cqc.org.uk\/publications\/themed-work\/ethnic-minority-led-gp-practices-impact-experience-cqc-regulation"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-7568(21)00146-X"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.3399\/BJGPO.2021.0204"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-003320"},{"key":"ref41","unstructured":"WattTRaymondARachet-JacquetLQuantifying health inequalities in EnglandThe Health Foundation20222023-04-17https:\/\/www.health.org.uk\/news-and-comment\/charts-and-infographics\/quantifying-health-inequalities"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.o1149"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.2196\/37436"}],"container-title":["JMIR Public Health and Surveillance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publichealth.jmir.org\/2023\/1\/e44944","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:49:50Z","timestamp":1782841790000},"score":1,"resource":{"primary":{"URL":"https:\/\/publichealth.jmir.org\/2023\/1\/e44944"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,2]]},"references-count":43,"URL":"https:\/\/doi.org\/10.2196\/44944","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.44944","asserted-by":"object"}]},"ISSN":["2369-2960"],"issn-type":[{"value":"2369-2960","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,2]]}}}