Impact of COVID-19 on public attitudes to engaging with the healthcare system

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Impact of COVID-19 on

public attitudes to engaging with the healthcare system

JULY 2020

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Introduction

The COVID-19 pandemic is posing unprecedented challenges to healthcare systems across Europe.

As the initial wave of the pandemic in Europe subsides, governments are considering how best to safely restart services. In order to assess public attitudes to using health services in a COVID-19 endemic world, as well as their priorities for the restarts, Incisive Health commissioned polling across France, Germany, Italy, Spain and the UK.

This briefing provides an overview of the key findings.

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Fear of COVID-19 is impacting on people’s

willingness to engage with the healthcare system

Due to the risk of catching COVID-19, people remain “scared” to use health services, with fear of using secondary care services particularly notable. Just under half (49%) of respondents reported that they are scared to visit an A&E department, whilst 4 out of 10 (39%) are concerned about using an ambulance for the same reason. By comparison, only 24% feared a trip to the pharmacist due to the risk posed by the pandemic.

Figure 1:

“Due to the risk of catching COVID-19, I am scared to use the following health services”

¹

People in countries that have been hardest hit by the pandemic are most concerned about using hospital services. Figure 2 shows that 61% of respondents from Spain and 56% respondents from Italy reported fear of using A&E departments due to risk of catching COVID-19, whilst this was true for only 38% respondents from Germany.

Figure 2:

“Due to the risk of catching COVID-19, I am scared to use the following health services”

¹

Hospital emergency department

Hospital based specialist

Dentist practice

Ambulance service

GP practice

Physiotherapy Private specialist

Other health service

Pharmacy 49%

42% 42%

39% 39%

34% 32%

27% 24%

Almost half of respondents are “scared” of using emergency departments due to perceived risk of catching COVID-19

UK

67%

Spain Germany France Italy

Dentist practice

Ambulance service

GP practice

45% 45%

41%

35%

40%

51% 49% 49% 49%

38%

35%33% 32%

30%

47%

37%

42%

37% 37%

56%

42%

45% 43%

38%

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People are also reluctant to engage due to concerns that they will overburden health services during a time of crisis. As Figure 3 illustrates, 57% of respondents from Spain and 48% respondents from the UK reported that they are reluctant to visit their GP over concerns to take up their time and capacity. Again, concern about overburdening health services is significantly lower in Germany (37% for GP practices).

Figure 3:

“ I am reluctant to use the following health services because I don’t want to take up their time and capacity during the pandemic”

²

UK Spain Germany France Italy

GP practice

Ambulance service

52%

48%

53%

47%

The implications of reluctance to engage with health services are significant.

The pandemic response has resulted in delays to the diagnosis and treatment of many patients and services will now be tasked with addressing this backlog. For example, data from the UK indicates that over 2 million people are now waiting for a cancer screening test, diagnosis or treatment.

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It will only be possible to manage this backlog if the public can be reassured that it is safe to use healthcare and that doing so will not place an unmanageable burden on services.

Cancer services are the public’s priority for reopening the health system

When it comes to reopening health systems, cancer services are the public’s top priority across Europe. More than half (54%) of respondents identified cancer screening and treatment as one of their top priorities. Cancer is a particular priority for people in Italy (62%), Spain (58%) and the UK (55%). By contrast 4 in 10 (43%)

of respondents from Germany identified it as a priority. Cancer is the public’s top priority for reopening health services

67%

57%

63%

60%

45%

37%

42% 41%

56%

40%

48% 50%

60%

41%

55%

51%

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Figure 4:

In your opinion, which areas of health services should be prioritised when reopening the healthcare system?*

UK

55%

Cancer diagnosis

& treatment

Primary care services (e.g.

GP practices)

Routine operations (e.g.

hip replacement)

Appointments for long term conditions

Mental health support

34%

20%

36% 35%

Primary care services were the second priority, selected by more than a third (38%) of respondents. Support for prioritising primary care was particularly strong in Spain (51%).

It is notable that, despite the focus on discovering an effective vaccine for COVID-19, there was relatively little focus on reopening vaccination services.

Telephone consultations preferred over face-to-face appointments for non-urgent medical advice

A feature of the response to the pandemic has been the adoption of approaches to reduce the risk of exposure to infection, such as moving to virtual appointments where possible.

This is broadly supported by the public, with just under one third (30%) of respondents preferring a telephone appointment, just under a quarter (24%) still preferring a face-to-face appointment and one in five (20%) preferring a video call for a non-urgent appointment.

Vaccination services

*Respondents were able to choose up to three priorities

20%

58%

51%

23%

28% 29% 29%

43%

32%

19%

22%

27%

20%

53%

36%

16%

42%

21%19%

62%

39%

28%

31%

24% 25%

Figure 5:

If you needed non-urgent medical advice, what would be your preferred method of receiving it?

Telephone call appointment Personal face-to-face appointment Online video appointment Using online services and/or apps to help manage my health Other

30%

24%

20%

15%

1%

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Telephone consultations are preferred over face-to-face appointments for non-urgent medical advice However, attitudes vary across countries. Figure 6 shows that more than a third (37%)

of respondents in France say their preferred method of receiving non-urgent medical advice would still be a personal face-to-face appointment, compared to under a fifth (18%) of respondents in Italy who said the same.

Figure 6:

If you needed non-urgent medical advice, what would be your preferred method of receiving it?

The public wants further action to recruit and protect healthcare professionals in preparation for a second wave

As healthcare systems prepare for a potential second wave of the pandemic, respondents to our survey want to see action to recruit and protect healthcare professionals. Nearly half (48%) of respondents identified investing in personal protective equipment (PPE) to ensure the safety of doctors and nurses as one of their top priorities, followed by recruiting more doctors and nurses (38%).

Figure 7:

In view of a potential second wave of COVID-19 over the next 18 months, which areas of healthcare services should be prioritised now in order to prepare for such an event?*

Recruiting and protecting the medical workforce is crucial for preparing for second COVID-19 wave

UK Spain Germany France Italy

Telephone call appointment

Online video appointment

34%

17% 18% 17%

Using online services and/or apps to help manage my health

38%

20% 20%

15%

31%

13%

26%

13% 15%

27%

37%

10%

31%

24%

18%20%

*Respondents were able to choose up to three priorities Investing in PPE to protect doctors and nurses

Recruiting more doctors and nurses Stockpiling medical equipment (e.g. ventilators) Increasing intensive care capacity Improving social care services (e.g. care homes) Backlog of medical appointments and waiting lists Retaining existing doctors and nurses

50%

40%

30%

20%

10%

0%

Personal face-to-face appointment

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Increasing intensive care capacity is less of a priority for those countries where capacity was not breached, such as Germany (24%) and the UK (24%). Focus on this issue is higher in Spain (42%), France (44%) and Italy (44%) (Figure 8).

Figure 8:

In view of a potential second wave of COVID-19 over the next 18 months, which areas of healthcare services should be prioritised now in order to prepare for such an event?*

Preparing for future pandemics

As well as preparing for a second wave of the COVID-19 pandemic, respondents were asked to consider the steps they would take to prepare for future potential pandemics.

Figure 9 shows that investment in medical research, stockpiling PPE, investing in intensive care capacity and improving international cooperation were identified as the priorities.

Over half (54%) of respondents chose investing in medical research, closely followed by investment in PPE (51%), intensive care capacity (51%) and international cooperation (51%).

Support for improved international cooperation was strongest in Germany (55%) and weakest in France and the UK (both 47%).

UK

24%

Increasing intensive care capacity

Addressing backlog of delayed appointments Recruiting more doctors and nurses

30%

25%

45%

30%

*Respondents were able to choose up to three priorities

25%

42%

39%

18%

61%

48%

19%

24%

30%

15%

41%

34%

16%

44% 44%

19%

45%

38%

14%

44%

38%

17%

50%

40%

13%

Stockpiling medical equipment Investing in PPE for doctors and nurses Retaining existing doctors and nurses

Medical research

and stockpiling

PPE are considered

the first steps in

preparing for future

potential pandemics

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Figure 9:

What should healthcare systems do now to be better prepared for potential pandemics in the future?*

*Respondents were able to choose up to three priorities Investing in more medical research

Stockpiling PPE Investing in intensive care capacity Improving cooperation between different countries Investing in tools to track infections Healthcare services shouldn’t do anything to be better prepared for future pandemics

50%

40%

30%

20%

10%

0%

Methodology

• The survey was conducted by Censuswide between 29 May 2020 and 03 June 2020

• The survey included 2,000 adults per country from France, Germany, Italy, Spain and the UK, nationally representative in terms of gender and age

• Censuswide abide by and employ members of the Market Research Society which is based on the ESOMAR principles

REFERENCES

1 Respondents selected ‘Strongly agree’ or ‘Agree’ when asked to what extent they agreed or disagreed with the statement “Due to the risk of catching COVID-19, I am scared to use the following health services”

2 Respondents selected ‘Strongly agree’ or ‘Agree’ when asked to what extent they agreed or disagreed with the statement “I am reluctant to use the following health services because I don’t want to take up their time and capacity during the pandemic”

3 Cancer Research UK, Over 2 million people waiting for cancer screening, tests and treatments, June 2020