The cost of primary care consultations associated with long COVID in non-hospitalised adults

Tufts, J. et al. | The cost of primary care consultations associated with long COVID in non-hospitalised adults: a retrospective cohort study using UK primary care data | BMC Primary. Care 24, 245 (2023) | https://doi.org/10.1186/s12875-023-02196-1

The economic impact of managing long COVID in primary care is unknown. We estimated the costs of primary care consultations associated with long COVID and explored the relationship between risk factors and costs.

Based on an analysis of 472,173 patients with COVID-19 and 472,173 unexposed individuals, the annual incremental cost of primary care consultations associated with long COVID was £2.44 per patient and £23,382,452 at the national level. Among patients with COVID-19, a long COVID diagnosis and reporting of longer-term symptoms were associated with a 43% and 44% increase in primary care consultation costs respectively, compared to patients without long COVID symptoms. Older age, female sex, obesity, being from a white ethnic group, comorbidities and prior consultation frequency were all associated with increased primary care consultation costs.

The costs of primary care consultations associated with long COVID in non-hospitalised adults are substantial. Costs are significantly higher among those diagnosed with long COVID, those with long COVID symptoms, older adults, females, and those with obesity and comorbidities.

Full paper: The cost of primary care consultations associated with long COVID in non-hospitalised adults: a retrospective cohort study using UK primary care data

Prognostic factors for persistent fatigue after COVID-19

British Journal of General Practice | February 2023 | BJGP.2022.0158. DOI: https://doi.org/10.3399/BJGP.2022.0158

Persistent fatigue after COVID-19 is common; however, the exact incidence and prognostic factors differ between studies. Evidence suggests that age, female sex, high body mass index, and comorbidities are risk factors for long COVID. The aim of this study was to investigate the prevalence of persistent fatigue after COVID-19 in patients with a mild infection (managed in primary care) during the first wave of the pandemic and to determine prognostic factors for persistent fatigue.

Prognostic factors for persistent fatigue included low education level, absence of a partner, high neuroticism (using the Eysenck Personality Questionnaire Revised-Short Form), low resilience, high frequency of GP contact, medication use, and threatening experiences in the past. The latter three factors appeared to be prognostic factors for persistent fatigue specifically after COVID-19 infection.

The study concludes that GP patients with COVID-19 (who were not admitted to hospital with COVID) have a fourfold higher chance of developing persistent fatigue than GP patients who had not had COVID-19. This risk is even higher in psychosocially vulnerable patients who had COVID-19.

Full paper: Prognostic factors for persistent fatigue after COVID-19: a prospective matched cohort study in primary care

Role of general practice teams in supporting patient access to COVID-19 treatments

via NHS England

To help GP teams and reception staff deal with queries from patients on treatments for COVID-19, NHS England have produced a fact sheet which explains the pathway. The factsheet can be shared and printed for reception staff and will help ensure that potentially eligible patients receive an urgent triage call or review with the practice clinical team and, where appropriate, a referral to a COVID-19 Medicine Delivery Unit.

Full details on how GP teams can help support access to COVID-19 antivirals can be found in the letter issued to GPs in May 2022.

Factsheet: Role of general practice teams in supporting patient access to COVID-19 treatments

Coronavirus (COVID-19) latest insights

Latest data and trends about the coronavirus pandemic from the Office for National Statistics and other sources.

COVID-19 infections continued to increase in England, and began to rise in Wales and Scotland, in the week ending 3 December 2022. The trend was uncertain in Northern Ireland. The estimated percentage of people living in private households (those not in care homes or other communal establishments) testing positive for COVID-19 was:

• 2.01% in England (1 in 50 people)
• 1.84% in Wales (1 in 55 people)
• 2.11% in Northern Ireland (1 in 45 people)
• 1.91% in Scotland (1 in 50 people)

Meanwhile, the number of deaths involving COVID-19 in the UK continued to fall from 400 to 372 in the latest week (ending 2 December 2022). Deaths involving COVID-19 accounted for 2.9% of all deaths in the UK in the latest week; this is a fall from 3.1% in the previous week.

Full detail: Coronavirus (COVID-19) latest insights

Elective Recovery Taskforce to tackle COVID-19 backlogs

The government is setting up an Elective Recovery Taskforce to help the NHS deliver on waiting list targets, bringing together a range of healthcare experts | Department of Health and Social Care

Patients will benefit from quicker access to treatment and lifesaving diagnostic tests close to home following the launch of a new Elective Recovery Taskforce and approval of 19 new one-stop-shops for tests, checks and scans. The new diagnostic centres will be located in the heart of communities across the country including football stadiums and shopping centres offering a range of services including MRI, CT and x-rays, making tests more accessible for patients.

The taskforce will bring together a group of experts to work on a series of recommendations which will be put to the government early next year on how the NHS can better commission the independent sector to support the NHS. The taskforce will look to improve communication and collaboration between the NHS and independent sector, clearly setting out what theatres, beds and other settings (such as outpatients) are available in the independent sector.

Full detail: Government turbocharges efforts to tackle COVID-19 backlogs

The urgent need to address growing health inequalities and protect our health in the face of an economic crisis

This report from The British Medical Association (BMA) calls for urgent action to protect the nation’s health and address growing inequalities.

Before COVID-19, the nation’s health was already deteriorating. In 2011, long-term gains in life expectancy began to stall, and since then, a decade of austerity has widened health inequalities. The amount of time that people spend in poor health has also increased, and the gap in healthy life expectancy between the most and least deprived areas is now almost 20 years. The pandemic made matters substantially worse, and the current cost-of-living crisis will also have considerable implications for people’s health.

This report calls for urgent action to protect our health and address growing inequalities. In particular the BMA wants:

1. To see people’s economic security protected. No one should be left unable to afford a healthy life.
2. To see our public services protected. Public services must be properly funded, not eroded.
3. To see the protection and introduction of policies that keep us well. There must be no more delays to the policies that prevent and tackle ill health.

Full report: The country is getting sicker. The urgent need to address growing health inequalities and protect our health in the face of an economic crisis.

Press release: Our country is getting sicker

Impact of the COVID-19 pandemic on timeliness and equity of measles, mumps and rubella vaccinations in North East London

Firman N. et al | Impact of the COVID-19 pandemic on timeliness and equity of measles, mumps and rubella vaccinations in North East London: a longitudinal study using electronic health records | BMJ Open | 2022;12:e066288. doi: 10.1136/bmjopen-2022-066288

The authors of this study looked to quantify the effect of the COVID-19 pandemic on the timeliness of, and geographical and sociodemographic inequalities in, receipt of first measles, mumps and rubella (MMR) vaccination. The study which included 285 general practices in North East London found the pandemic was associated with a 4.0% reduction in timely MMR vaccine receipt. It found increased geographical clustering of measles susceptibility in an area of historically low and inequitable MMR coverage.

The authors conclude Immediate action is needed to avert measles outbreaks and support primary care to deliver timely and equitable vaccinations.

Full paper: Impact of the COVID-19 pandemic on timeliness and equity of measles, mumps and rubella vaccinations in North East London: a longitudinal study using electronic health records

Stressed Out and Burned Out: The Global Primary Care Crisis

Findings from the 2022 International Health Policy Survey of Primary Care Physicians | The Commonwealth Fund

This briefing presents the first findings from the 2022 Commonwealth Fund International Health Policy Survey of Primary Care Physicians to explore the effects of the pandemic on the primary care workforce across nations. Conducted in ten high-income countries, it compares changes in workload, stress, emotional distress, burnout, quality of care delivered, and career plans.

Survey Highlights:

• Across the 10 high-income countries included in this study, most physicians reported increases in their workload since the beginning of the pandemic.
• Younger physicians (under age 55) were more likely to experience stress, emotional distress, or burnout and, in nearly all countries, were more likely to seek professional help compared to older physicians.
• Physicians who experienced stress, emotional distress, or burnout were more likely to report providing worse quality of care compared to before the pandemic.
• Half or more of older physicians in most countries reported they would stop seeing patients within the next three years, leaving a primary care workforce made up of younger, more stressed, and burned-out physicians.

Full detail: Stressed Out and Burned Out: The Global Primary Care Crisis

COVID-19: notification to GPs and NHS England to share information

Notification to GPs and NHS England that they should share information to support efforts against coronavirus (COVID-19) | Department of Health and Social Care

The secretary of state has issued a notice under the Health Service Control of Patient Information Regulations 2002 requiring GPs and NHS England to process information. This notice requires that data is shared for purposes of COVID-19. Effective compliance with the notice will be demonstrated by use of the OpenSAFELY data analytics platform.

For patients, this means that their data may be shared with these organisations in relation to the response to COVID-19. If no further notice is sent, it will expire on 30 April 2023.

Full detail: COVID-19: notification to GPs and NHS England to share information

Maximising uptake of antenatal vaccinations during the autumn COVID-19 booster and flu vaccine programmes

NHS England – Document first published: 13 October 2022, Page updated: 13 October 2022

This letter sets out the essential role of maternity and vaccination services in advising pregnant women of their eligibility for vaccination against COVID-19, flu and pertussis, and facilitating easy access to these vaccines.

Full letter: Maximising uptake of antenatal vaccinations during the autumn COVID-19 booster and flu vaccine programmes