Objectives:
To identify the risk of general practitioner mortality from COVID and the impact of measures to mitigate this risk on the level and socioeconomic distribution of primary care provision in the English NHS
Design:
Cross sectional study
Setting:
All GP practices providing primary care under the NHS in England
Participants:
45,858 GPs and 6,771 GP practices in the English NHS
Main outcome measures:
Numbers of high-risk GPs, high-risk single-handed GP practices, patients associated with these high-risk single-handed practices and the regional and socioeconomic distribution of each. Mortality rates from COVID by age, sex and ethnicity were used to attribute risk to GPs and the Index of Multiple Deprivation was used to determine socioeconomic distributions of the outcomes.
Results:
Of 45,858 GPs in our sample 3,632 (7.9%) were classified as high risk or very high risk. Of 6,771 GP practices in our sample 639 (9.4%) were identified as single-handed practices and of these 209 (32.7%) were run by a GP at high or very high risk. These 209 single-handed practices care for 710,043 patients. GPs at the highest levels of risk from COVID, and single-handed practices run by high-risk GPs were concentrated in the most deprived neighbourhoods in the country. London had the highest proportion of both GPs and single-handed GP practices at very high risk of COVID mortality with 1,160 patients per 100,000 population registered to these practices.
Conclusions:
A significant proportion of GPs working in England, particularly those serving patients in the most deprived neighbourhoods, are at high risk of dying from COVID. Many of these GPs run single-handed practices. These GPs are particularly concentrated in London. There is an opportunity to provide additional support to mitigate COVID risk for GPs, GP practices and their patients. Failure to do so will likely exacerbate existing health inequalities.
The impact of integrated disease management in high-risk COPD patients in primary care
