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Project #152:
Digital access to primary care for older people during COVID

For at least a decade, the World Health Organization and the NHS have been encouraging use of digital technology to improve health and care services. This has expanded during the COVID-19 pandemic, where lockdowns and social restrictions have been accompanied by rapid roll-out of digital technologies to maintain access to health and care services. Government policy outlines a ‘digital first’ vision that prioritises the development of digital access to health and care services, e.g., by the NHS App as the ‘front door’ to the NHS. However, there concerns that older people are being disadvantaged and excluded with the increased use of digital technologies. The NIHR Older People and Frailty Policy Research Unit has conducted two evidence reviews exploring the impact of digital technologies on older people’s access to health and care. The first, conducted before the pandemic, found a lack of evidence that digital technologies could support older people’s access to health and care. The second has looked at what research has been conducted on the digitalisation of health and care services since the start of the pandemic. Most research so far has been small-scale and has focused on telephone access. There is an urgent need for detailed analysis of the impacts of pandemic-driven digitalisation of health and care services on older people. In particular, there is a need for a focus on potential health inequalities among different groups of older people (e.g., socioeconomic and ethnic groups). In this study, we propose to analyse electronic medical records in England to explore the impact on older people of digitalised GP access during the pandemic. We will analyse data from adult patients aged at least 18 who were registered with GPs between January 2019 to February 2022, with a specific interest in comparing consultation data for those aged under 65 and 65+.