IFS - Over 3.5 million people aged over 50 had hospital treatment cancelled between February and May

9 Nov 2020 01:57 PM

During the early stages of the pandemic, delivery of routine healthcare was changed dramatically in order to prioritise COVID patients’ care and minimise the risk of COVID infection in healthcare settings.

As a second national lockdown begins in England, a new report produced by researchers at the Institute for Fiscal Studies, funded by the Economic and Social Research Council (ESRC) as part of UK Research and Innovation’s rapid response to COVID-19, shows that access to health care services for the over 50s was hugely disrupted during the early stage of the pandemic.

Drawing on new data from the English Longitudinal Study of Ageing (ELSA) Covid-19 study, a survey of adults in their 50s and over in Summer 2020, researchers find that those in poor health initially and those in more deprived areas were most likely to lose access to treatment they needed.

Looking at levels of healthcare disruption for the over-50 population in England, researchers also find that:

• A sixth of the over-50 population in England – that is 3.6 million individuals – had some hospital treatment cancelled between February and May in 2020.
• Hospital cancellations were most common for heavy users of hospital services. Older people, those living in more deprived areas, and those with worse self-reported health were most likely to experience a postponement or cancellation of their care.
• GP care was also disrupted. Almost a quarter of those reporting that they needed to speak to a GP did not manage to do so. Among those who contacted a GP, those with worse prior health were twice as likely as those in excellent prior health to be unable to access their GP when needed: 13% of those who reported ‘poor’ or ‘fair’ health failed to see a GP when attempting to do so, compared with just 6% among those in ‘excellent’ health. In addition, 14% of those requiring GP care across all health categories did not even attempt to contact them.
• Almost three-quarters of those who reported needing community health and social care, did not get it. More than a third of those who needed these services did not seek help in the first place, with an additional 41% of would-be users unable to access the service after contacting it.
• Those living in the most deprived areas were also more likely to be affected: among those who tried to access community and social care services, 46% of those in the most deprived areas did not get access compared to 37% of those in the least deprived areas.
• Much more impressively, access to prescription medication continued largely unaffected. Less than 1% of the population reported that they could not access their regular medication.
• In addition to changes in access to care, care-seeking behaviour changed radically in the early stages of the pandemic. 14% of those who reported requiring GP care, and more than a third of those reporting that they needed community care services, did not even attempt to contact these services.

Unlike in the Spring, the government has signalled its wish to maintain regular healthcare services as much as possible during the lockdown period. It remains to be seen how achievable this will be in coming months given the urgent need for resources to be diverted to treat Covid-19 patients, but even if disruption is minimised during this second wave the large backlog of cases is only likely to grow. This large backlog of care – especially in deprived areas - will likely exacerbate health inequalities for years to come. These findings underline the importance of boosting capacity to address care backlogs as soon as possible, and ensuring the access to wider care services are maintained where possible during difficult times.

Isabel Stockton, a Research Economist at the Institute for Fiscal Studies and a co-author of the study, said:

“Many older people have seen their healthcare disrupted during the pandemic, and the burden has disproportionately fallen on those who were already disadvantaged and in poor health. As we move into another lockdown, it will be crucial to ensure access to routine care is maintained as much as possible and that a plan is in place to address care backlogs built up in the first few months of the pandemic. Without this commitment, we risk entrenching existing health inequalities for years to come.”

COVID-19 and disruptions to the health and social care of older people in England