Project #197:
Neurosurgery Referrals during the COVID-19 Pandemic: A retrospective cohort study using OpenSAFELY

When someone has a health issue that their GP cannot fully manage, they are usually referred to a specialist. This process plays a crucial role in making sure people receive the right care at the right time. For urgent conditions, like those affecting the brain or spine, a timely referral can make a huge difference to a person’s outcome.

The COVID-19 pandemic disrupted nearly every part of healthcare. Hospitals and GP practices had to change the way they worked almost overnight. Staff were under huge pressure, routine tests were harder to access, and many services were paused or restructured. These changes likely affected how and when referrals to specialists were made. Some patients may have found it harder to get referred, while others may have been referred in different ways than before.

This study focuses on how referrals to neurosurgery changed during the pandemic. Neurosurgery deals with problems involving the brain, spine, and nerves. These conditions are often serious and need urgent attention. Because of this, referrals in this area offer a clear and meaningful way to understand how the healthcare system adapted under pressure.

The research uses OpenSAFELY, a secure NHS platform that allows researchers to analyse large-scale health data while protecting patient privacy. In an earlier phase of the project, the team looked at what kind of referral data is available and how it is recorded. This next step builds on that work to examine how referral volumes and patterns changed before, during, and after the COVID-19 pandemic.

By studying national trends in neurosurgical referrals, the team hopes to better understand the lasting impact of the pandemic on access to care. The findings will help support the NHS’s recovery, improve how referrals are handled in future, and strengthen the system’s ability to respond to future health emergencies.