eLife (Jul 2023)
Eleven key measures for monitoring general practice clinical activity during COVID-19: A retrospective cohort study using 48 million adults’ primary care records in England through OpenSAFELY
- Louis Fisher,
- Helen J Curtis,
- Richard Croker,
- Milan Wiedemann,
- Victoria Speed,
- Christopher Wood,
- Andrew Brown,
- Lisa EM Hopcroft,
- Rose Higgins,
- Jon Massey,
- Peter Inglesby,
- Caroline E Morton,
- Alex J Walker,
- Jessica Morley,
- Amir Mehrkar,
- Seb Bacon,
- George Hickman,
- Orla Macdonald,
- Tom Lewis,
- Marion Wood,
- Martin Myers,
- Miriam Samuel,
- Robin Conibere,
- Wasim Baqir,
- Harpreet Sood,
- Charles Drury,
- Kiren Collison,
- Chris Bates,
- David Evans,
- Iain Dillingham,
- Tom Ward,
- Simon Davy,
- Rebecca M Smith,
- William Hulme,
- Amelia Green,
- John Parry,
- Frank Hester,
- Sam Harper,
- Jonathan Cockburn,
- Shaun O'Hanlon,
- Alex Eavis,
- Richard Jarvis,
- Dima Avramov,
- Paul Griffiths,
- Aaron Fowles,
- Nasreen Parkes,
- Brian MacKenna,
- Ben Goldacre
Affiliations
- Louis Fisher
- ORCiD
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Helen J Curtis
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Richard Croker
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Milan Wiedemann
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Victoria Speed
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Christopher Wood
- ORCiD
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Andrew Brown
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Lisa EM Hopcroft
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Rose Higgins
- ORCiD
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Jon Massey
- ORCiD
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Peter Inglesby
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Caroline E Morton
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Alex J Walker
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Jessica Morley
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Amir Mehrkar
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Seb Bacon
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- George Hickman
- ORCiD
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Orla Macdonald
- Oxford Health Foundation Trust, Warneford Hospital, Oxford, United Kingdom
- Tom Lewis
- Royal Devon University Healthcare NHS Foundation Trust, Barnstaple, United Kingdom
- Marion Wood
- NHS England, London, United Kingdom
- Martin Myers
- Lancashire Teaching Hospitals NHS Foundation Trust, Chorley, United Kingdom
- Miriam Samuel
- Queen Mary University of London, London, United Kingdom
- Robin Conibere
- Beacon Medical Group, Plymouth, United Kingdom
- Wasim Baqir
- NHS England, London, United Kingdom
- Harpreet Sood
- Sternhall Lane Surgery, London, United Kingdom
- Charles Drury
- Herefordshire and Worcestershire Health and Care NHS Trust, Worcester, United Kingdom
- Kiren Collison
- NHS England, London, United Kingdom
- Chris Bates
- TPP, Leeds, United Kingdom
- David Evans
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Iain Dillingham
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Tom Ward
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Simon Davy
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Rebecca M Smith
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- William Hulme
- ORCiD
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Amelia Green
- ORCiD
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- John Parry
- TPP, Leeds, United Kingdom
- Frank Hester
- TPP, Leeds, United Kingdom
- Sam Harper
- TPP, Leeds, United Kingdom
- Jonathan Cockburn
- TPP, Leeds, United Kingdom
- Shaun O'Hanlon
- EMIS, Leeds, United Kingdom
- Alex Eavis
- EMIS, Leeds, United Kingdom
- Richard Jarvis
- EMIS, Leeds, United Kingdom
- Dima Avramov
- EMIS, Leeds, United Kingdom
- Paul Griffiths
- EMIS, Leeds, United Kingdom
- Aaron Fowles
- EMIS, Leeds, United Kingdom
- Nasreen Parkes
- EMIS, Leeds, United Kingdom
- Brian MacKenna
- ORCiD
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom; NHS England, London, United Kingdom
- Ben Goldacre
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- DOI
- https://doi.org/10.7554/eLife.84673
- Journal volume & issue
-
Vol. 12
Abstract
Background: The COVID-19 pandemic has had a significant impact on delivery of NHS care. We have developed the OpenSAFELY Service Restoration Observatory (SRO) to develop key measures of primary care activity and describe the trends in these measures throughout the COVID-19 pandemic. Methods: With the approval of NHS England, we developed an open source software framework for data management and analysis to describe trends and variation in clinical activity across primary care electronic health record (EHR) data on 48 million adults. Results: We produced 11 measures reflective of clinical activity in general practice. A substantial drop in activity was observed in all measures at the outset of the COVID-19 pandemic. By April 2021, the median rate had recovered to within 15% of the median rate in April 2019 in six measures. The remaining measures showed a sustained drop, ranging from a 18.5% reduction in medication reviews to a 42.0% reduction in blood pressure monitoring. Three measures continued to show a sustained drop by December 2021. Conclusions: The COVID-19 pandemic was associated with a substantial change in primary care activity across the measures we developed, with recovery in most measures. We delivered an open source software framework to describe trends and variation in clinical activity across an unprecedented scale of primary care data. We will continue to expand the set of key measures to be routinely monitored using our publicly available NHS OpenSAFELY SRO dashboards with near real-time data. Funding: This research used data assets made available as part of the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant ref MC_PC_20058).The OpenSAFELY Platform is supported by grants from the Wellcome Trust (222097/Z/20/Z); MRC (MR/V015757/1, MC_PC-20059, MR/W016729/1); NIHR (NIHR135559, COV-LT2-0073), and Health Data Research UK (HDRUK2021.000, 2021.0157).
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