Barriers in accessing healthcare during the COVID-19 pandemic: analysis of the Virus Watch community cohort study

Background: Differential barriers to accessing healthcare contribute to inequitable health outcomes. This study aims to describe the characteristics of individuals who experienced barriers, and what those barriers were, during the COVID-19 pandemic. Methods: We analysed data from Virus Watch: an online survey-based community study of households in England and Wales. The primary outcome was reported difficulty accessing healthcare in the previous year. Results: Minority ethnic participants reported difficulty accessing healthcare more than White British participants (41.6% vs 37%), while for migrants this was at broadly similar levels to non-migrants. Those living in the most deprived areas reported difficulty more than those living in the least deprived quintile (45.5% vs. 35.5%). The most frequently reported barrier was cancellation/disruption of services due to the COVID-19 pandemic (72.0%) followed by problems with digital or telephone access (21.8%). Ethnic minority participants, migrants, and those from deprived areas more commonly described 'insufficient flexibility of appointments' and 'not enough time to explain complex needs' as barriers. Conclusions: Minority ethnic individuals and those living in deprived areas were more likely to experience barriers to healthcare during the COVID-19 pandemic, and it is essential they are addressed as services seek to manage backlogs of care.