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They have called for referral systems to be reviewed and improved, to make sure every community is served equally. They also concluded that some of the systems to identify vulnerable COVID-19 patients were inefficient.

Vulnerable COVID-19 patients from more deprived communities were less likely to access treatment during the height of the pandemic than better off groups, a review by Nottingham researchers has found.

The results are published in peer-reviewed journal PLOS ONE, at https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0281915

Clinical Lecturer Dr Amanda Goodwin, describes the study:

They looked at data for 1820 patients from the Nottingham Covid Medicines Delivery Unit (CMDU) from December 2021 to February 2022, covering age, sex and ethnicity and whether they were in a deprived community, as well as referral reasons, vaccinations, treatments, hospital admissions, complications, other treatment and mortality.

Clinical research has shown how antivirals and monoclonal antibodies reduced hospitalisation and death for vulnerable people with Covid-19, and this study looked at how effective they are in the real world, which is affected by other factors like social conditions and ease of accessing treatment.

The researchers, from National Institute for Health and Care Research Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, and the University of Nottingham, also concluded:

• people who are white, female, and from less deprived areas were more likely to access treatment through the unit
• UK referral pathways for outpatient treatment of Covid-19 are inefficient
• adverse outcomes in high risk patients are rare, bringing the cost-effectiveness of treatment into doubt
• ongoing service evaluation is needed to inform policy worldwide.

Dr Goodwin said: “Our study isn’t big enough to be certain why less deprived groups were more likely to accept treatment at the unit, but other research into accessing healthcare in general indicates it might have been easier for them to get time off work for appointments, or to travel.

“It’s a concern that some groups were less likely to accept NHS treatments, but this is consistent with other reports that patients from more deprived areas may receive poorer quality healthcare. This may be related to differences in how much different patient groups trust or understand these treatments and NHS pathways, or in the ways patients convey their symptoms to healthcare professionals . We need more research to pinpoint the barriers to accessing healthcare and find potential solutions.”