Abstract
BACKGROUND: The COVID-19 pandemic led to a rapid transformation of the operating model for GP practices in England, with a switch towards the use of remote rather than face-to-face appointments. AIM: To assess changes in the quality of general practice in England over the course of the COVID-19 pandemic based on patients' views of their experiences. DESIGN & SETTING: Analysis of practice-level multicategory response data on patient-reported experience measures (PREMs) from annual GP Patient Surveys from 2018-2023. METHOD: Healthcare quality changes (HQC) at both practice and national levels were assessed. An index sensitive to changes in the distribution of patient responses was used across the full set of PREM response categories, not just in the proportion meeting a binary quality threshold. RESULTS: Patients' reported experience of general practice improved nationally between the 2020 and 2021 surveys, in spite of the restrictions on the operation of GP practices. The reported experiences then fell sharply between 2021 and 2022 before resuming the pre-pandemic downward trend. Variation in HQCs at the practice level was considerable between all consecutive years. CONCLUSION: Changes in patients' reports of their experiences of general practice over the course of the pandemic reflected broader shifts in public attitudes towards the NHS as well as real changes in the nature and quality of service delivery.