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 2020Introduction 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.
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
49%
42% 42%
39% 39%
34% Almost half of
32%
respondents
27%
24% are “scared” of
using emergency
departments
due to perceived
risk of catching
COVID-19
Hospital Hospital Dentist Ambulance GP Physiotherapy Private Other Pharmacy
emergency based practice service practice specialist health
department specialist service
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
67%
56%
51%
49% 49% 49%
47%
45% 45% 45%
42% 42% 43%
41% 40%
38% 37% 37% 37% 38%
35% 35%
33% 32%
30%
UK Spain Germany France Italy
Hospital Dentist Hospital Ambulance GP
emergency practice based service practice
department specialistPeople 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
67%
63%
60% 60%
57% 56% 55%
52% 53%
50% 51%
48% 47% 48%
45%
42% 41% 41%
40%
37%
UK Spain Germany France Italy
Hospital GP Ambulance Hospital
emergency practice service based
department specialist
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.3 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 servicesFigure 4:
In your opinion, which areas of health services should be prioritised when reopening
the healthcare system?*
62%
58%
55%
53%
51%
43%
42%
39%
36% 35% 36%
34%
32% 31%
28% 29% 29% 27% 28%
25%
23% 24%
22% 21%
20% 20% 20% 19%
19%
16%
UK Spain Germany France Italy
Cancer Primary care Routine Appointments Mental Vaccination
diagnosis services (e.g. operations (e.g. for long term health services
& treatment GP practices) hip replacement) conditions support
*Respondents were able to choose up to three priorities
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 Figure 5:
pandemic has been the adoption If you needed non-urgent medical advice, what would
of approaches to reduce the be your preferred method of receiving it?
risk of exposure to infection,
1%
such as moving to virtual
appointments where possible. Telephone call
appointment
This is broadly supported by the
15%
public, with just under one third Personal
face-to-face
(30%) of respondents preferring 30%
appointment
a telephone appointment,
Online video
just under a quarter (24%) 20% appointment
still preferring a face-to-face Using online services
appointment and one in five and/or apps to help
24% manage my health
(20%) preferring a video call
for a non-urgent appointment. OtherHowever, 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?
38%
37%
34%
31% 31% Telephone
26%
27%
24%
consultations
20% 20% 20%
are preferred
17% 18% 17% 18%
over face-to-face
15% 15%
13% 13% appointments
for non-urgent
10%
medical advice
UK Spain Germany France Italy
Telephone call Online video Personal Using online services
appointment appointment face-to-face and/or apps to help
appointment manage my health
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?*
Investing in PPE to protect doctors and nurses
Recruiting more doctors and nurses
Stockpiling medical equipment (e.g. ventilators)
Increasing intensive care capacity Recruiting and
Improving social care services (e.g. care homes) protecting
the medical
Backlog of medical appointments and waiting lists
workforce is
Retaining existing doctors and nurses crucial for
0% 10% 20% 30% 40% 50% preparing
for second
*Respondents were able to choose up to three priorities COVID-19 waveIncreasing 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?*
61%
50%
48%
45% 44% 44% 45% 44%
42%
41% 40%
39% 38% 38%
34%
30% 30% 30%
24% 25% 25% 24%
19% 19%
18%
16% 17%
15% 14%
13%
UK Spain Germany France Italy
Increasing intensive care capacity Stockpiling medical equipment
Addressing backlog of delayed appointments Investing in PPE for doctors and nurses
Recruiting more doctors and nurses Retaining existing doctors and nurses
*Respondents were able to choose up to three priorities
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%).
Medical research
and stockpiling
PPE are considered
the first steps in
preparing for future
potential pandemicsFigure 9:
What should healthcare systems do now to be better prepared for potential pandemics
in the future?*
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
0% 10% 20% 30% 40% 50%
*Respondents were able to choose up to three priorities
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 2020You can also read
