Evidence map›Paper›PMID 37068964›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2023

OpenSAFELY NHS Service Restoration Observatory 2: changes in primary care clinical activity in England during the COVID-19 pandemic.

Helen J Curtis, Brian MacKenna, Milan Wiedemann, Louis Fisher, Richard Croker, Caroline E Morton, Peter Inglesby, Alex J Walker, Jessica Morley, Amir Mehrkar and 23 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

33 authors.

Helen J CurtisThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0003-3429-9576
Brian MacKennaThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0002-3786-9063
Milan WiedemannThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0003-1991-282X
Louis FisherThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0002-0295-3812
Richard CrokerThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0002-8114-9186
Caroline E MortonThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0003-0783-0042
Peter InglesbyThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0002-7784-1719
Alex J WalkerThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0003-4932-6135
Jessica MorleyThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0001-5221-4770
Amir MehrkarThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0002-2098-1278
Sebastian Cj BaconThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0002-6354-3454
George HickmanThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0002-6691-4046
David EvansThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0002-1100-079X
Tom WardThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0003-3743-1456
Simon DavyThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0001-9890-3619
William J HulmeThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0002-9162-4999
Orla MacdonaldThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0003-2774-0001
Robin ConibereBeacon Medical Group, Plymouth.
Tom LewisRoyal Devon University Healthcare NHS Foundation Trust, Barnstaple.
Martin MyersLancashire Teaching Hospitals NHS Foundation Trust, Preston.
Shamila WanninayakeThe Manor Surgery, Oxford.
Kiren CollisonNHS England and NHS Improvement, London.
Charles DruryHerefordshire and Worcestershire Health and Care NHS Trust, Worcester.
Miriam SamuelWolfson Institute of Population Health, Queen Mary University of London, London.
Harpreet SoodUniversity College London Hospitals NHS Foundation Trust, London.ORCID 0000-0002-2280-7345
Andrea CiprianiDepartment of Psychiatry, University of Oxford, Oxford.ORCID 0000-0001-5179-8321
Seena FazelDepartment of Psychiatry, University of Oxford, Oxford.ORCID 0000-0002-5383-5365
Manuj SharmaDepartment of Primary Care and Population Health, University College London, London.
Wasim BaqirNHS England and NHS Improvement, London.
Chris BatesTPP, Leeds.ORCID 0000-0003-0113-2593
John ParryTPP, Leeds.
Ben GoldacreThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.ORCID 0000-0002-5127-4728
OpenSAFELY Collaborative

Funding

Medical Research Council MC_PC_20030Medical Research Council MC_PC_20051Medical Research Council MC_PC_20058Medical Research Council MC_PC_20059Medical Research Council MR/W016729/1
6 · The paper itself

Abstract

backgroundThe COVID-19 pandemic has disrupted healthcare activity across a broad range of clinical services. The NHS stopped non-urgent work in March 2020, later recommending services be restored to near-normal levels before winter where possible.

aimTo describe changes in the volume and variation of coded clinical activity in general practice across six clinical areas: cardiovascular disease, diabetes, mental health, female and reproductive health, screening and related procedures, and processes related to medication. DESIGN AND

settingWith the approval of NHS England, a cohort study was conducted of 23.8 million patient records in general practice, in situ using OpenSAFELY.

methodCommon primary care activities were analysed using Clinical Terms Version 3 codes and keyword searches from January 2019 to December 2020, presenting median and deciles of code usage across practices per month.

resultsSubstantial and widespread changes in clinical activity in primary care were identified since the onset of the COVID-19 pandemic, with generally good recovery by December 2020. A few exceptions showed poor recovery and warrant further investigation, such as mental health (for example, for 'Depression interim review' the median occurrences across practices in December 2020 was down by 41.6% compared with December 2019).

conclusionGranular NHS general practice data at population-scale can be used to monitor disruptions to healthcare services and guide the development of mitigation strategies. The authors are now developing real-time monitoring dashboards for the key measures identified in this study, as well as further studies using primary care data to monitor and mitigate the indirect health impacts of COVID-19 on the NHS.

Indexed as

COVID-19Cohort StudiesEnglandFemaleHumansPandemicsPrimary Health CareState MedicineCOVID-19electronic health recordsgeneral practiceprimary health care

Identifiers

PMID37068964
PMCPMC10131234

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.