Impact of COVID-19 on primary care consultation mode in England:An interrupted time series analysis

Background: The COVID-19 pandemic significantly disrupted healthcare delivery worldwide, and general practice in England was no exception. The adoption of remote consultations in primary care increased sharply during the pandemic. However, there is no evidence that the adoption of remote consultation will continue in the long term. Objective: Long-term effects on primary care face-to-face and telephone consultations in England of the change towards remote consultation during COVID-19 pandemic. Method: We use Interrupted Time Series analysis to understand the long-term effects on primary care face-to-face and telephone consultations in England at both national and regional levels. Results: There was a shift in consultation patterns during and after the pandemic. Face-to-face consultations experienced a significant and immediate decline following the introduction of restrictions. However, they gradually increased and returned to pre-pandemic levels after restrictions were lifted, indicating that most healthcare needs still require in-person contact. Telephone consultations rose sharply during the pandemic. Although their use declined after restrictions eased in July 2021, they remained above pre-pandemic levels. Conclusion: The COVID-19 pandemic profoundly changed how general practice consultations are delivered in England, prompting a rapid shift to remote consultation methods. While telephone consultations surged when face-to-face contact was restricted, this increase was not sustained in the long term. Although remote consultations remained above pre-pandemic levels, they did not fully replace in-person visits. This suggests a dual use of resources rather than a substitution. Policy efforts should focus on balancing and supporting both remote and face-to-face consultation models.