One way in which the COVID-19 pandemic is likely to have impacted on peoples’ healthcare is by reducing their access to care. This describes a situation where someone is unwell enough that they would seek help from NHS services under normal circumstances but due to the pandemic was unable or unwilling to do so. A YouGov survey funded by the Health Foundation found that in May 2020, access to health services for people with pre-existing conditions was 20% lower during the first COVID-19 peak.
There are a number of potential barriers which may contribute to people having difficulty accessing NHS care during the pandemic, either for COVID-related symptoms or for something else. These may be barriers to do with the services themselves, for example, where certain services were suspended or reduced during the peak of the pandemic, or where GP practices were less able to see people in person due to physical distancing restrictions.
However, many barriers may be personal to an individual’s own circumstances, for example feeling their condition didn’t merit leaving their house during the initial phases of lockdown, being less able to use public transport where this is their only way to attend services, or having reduced finances as a result of being furloughed or losing their jobs. Finally, many may have experienced psychological barriers to seeking treatment, either because they feared the risk of infection visiting NHS premises or because they did not want to burden the service at a time of crisis.
There are some who may have been at greater risk of experiencing or being harmed by reduced access to care during COVID-19. These vulnerable groups include those with pre-existing conditions (particularly those whose conditions required them to ‘shield’ at home); young children; the elderly living in care homes; those on low incomes; and those who cannot easily access remote or online services from home. In addition, some people been reporting long-lasting symptoms, or ‘long COVID’, which can include lasting fatigue, persistent pain and breathlessness for months.
Developments in the vaccination programme offers some hope. The UK approved the first vaccine in December 2020 and started the rollout targeting elderly people, care home residents and workers, and NHS frontline staff in the first instance. Although the vaccines are shown to be effective at preventing severe illness, so far little is known about its effect on transmission rates. Therefore COVID-19 prevention measures remain the primary mode of protection and will likely be in place for the foreseeable future.