New diagnoses of common conditions halved in lockdown, GP figures show

The number of new diagnoses of common conditions in primary care halved during the height of the pandemic, say researchers who analysed GP data in a deprived population.

It suggests a large number of patients may have undiagnosed conditions and GPs may face a ‘rebound’ in workload as patients come forward, they conclude.

The figures prompted the RCGP to advise people not to be deterred from seeking medical advice.

Using data from GP records in Salford which cover approximately a quarter of a million people, researchers found a 50% drop in first diagnoses of several common conditions including mental health problems, diabetes, cardiovascular disease between 1 March and 31 May 2020 compared with the previous year.

It included a 50% reduction in common mental health problems, a 43% reduction in circulatory system diseases and a 49% reduction in diabetes diagnoses, the Lancet Public Health reported. 

The number of first prescriptions of associated medications was also lower than expected for the same time period, the researchers said.

But the data showed that the gap between observed and expected cancer diagnoses (31 fewer cases) was not statistically significant – a figure potentially be confounded by a time lag between diagnosis in hospital and recording of information in primary care, they concluded.

It is the first population-based study to assess and quantify the indirect impact of the Covid-19 emergency on potential missed diagnoses in primary care.

Presenting the data at the European Society of Clinical Microbiology and infectious Diseases Conference, the researchers said the figures likely showed a large number of diseases have gone undetected, undiagnosed and untreated.

And as people start to engage with health – either because of reduced fear of contracting Covid-19 in a healthcare setting or worsening symptoms – presentation rates could increase sharply they warned.

They concluded: ‘Prioritisation of people with these conditions over people with more minor illnesses will be important in primary care otherwise the backlog could plausibly overwhelm primary and secondary health-care services.’

In response to the research, RCGP chair Professor Martin Marshall said data from the College’s Research and Surveillance Centre had also shown a decrease in demand for routine GP consultations at the height of lockdown.

The fall in consultations was likely due to a number of factors including patients having concerns about accessing GP services or overburdening NHS service, a desire to follow official messaging to stay at home and that many specialist services were also restricted, so GPs might not have always been able to make referrals except in urgent cases, he said.

‘General practice has been open throughout the pandemic – and as a College we’ve worked to get the message out that stay at home guidance does not include when seeking medical care.

‘Demand for routine GP consultations has increased since the end of May and are now at near-normal levels for this time of year.’

He added: ‘During a pandemic, other health conditions do not cease to exist, and we’ve seen from health crises in the past that there are sometimes more deaths from conditions unrelated to the pandemic than the virus causing the pandemic itself.

‘As GPs and our teams approach a likely second wave of Covid-19, we do not want to see this happen and we urge patients who have concerns about their health to seek medical assistance, particularly if they have signs that could indicate serious conditions, such as cancer.’

It comes as GP leaders last week asked NHS England to issue a ‘correction’ to claims in the mainstream media that GPs are not currently offering face-to-face appointments.