How has the pandemic affected people’s help-seeking behaviour and attitudes?
From August to September last year, we worked with Cardiff University to carry out surveys and interviews to understand the real-world impact the coronavirus pandemic has been having on people’s help-seeking behaviour and attitudes.
Results
We found that 40.1% of people said they had experienced at least one potential cancer symptom during the first six months of the UK pandemic. Worryingly, nearly half (44.8%) of people who had potential cancer symptoms reported not contacting their GP for any symptom during this time, even for ‘red flag symptoms’ such as coughing up blood.
People gave a variety of reasons for putting off seeking medical help, including not wanting to waste healthcare professionals’ time (15.4%), not wanting to put extra strain on the NHS (12.6%), worry about catching COVID-19 (9.6%), not wanting to be seen as someone who makes a fuss (12%), and difficulty in getting an appointment with a particular healthcare professional (10.3%).
During our qualitative interviews, people mentioned putting their health concerns on hold to avoid burdening the NHS. For people that identified a new or changing symptom, they often attributed the symptom to a pre-existing health condition instead.
The interviews also showed that people were fearful of seeking medical help in hospitals, in part due to media reporting of COVID-19 at the time.
In contrast to their concerns, when interviewees had contacted their GP, they reported positive experiences. Interestingly, those we spoke to wanted to retain remote consulting as an option after the pandemic, with face-to-face appointments available based on clinical need.
Recommendations
These results show some clear problems for the public during the pandemic, although the right public messaging may help to address this. Recent help-seeking campaigns that have happened in some areas of the UK are a positive step. But, well-timed, evidence-led, nationally funded, and coordinated cancer awareness campaigns are needed to signal that cancer cannot wait and that NHS services are open safely for people with any unusual or persistent symptoms.
Credible patient stories with an emphasis on positive outcomes can be important in supporting engagement with hospital outpatient appointments, treatments, or investigations. These patient stories can counteract concerns and fears that arise from ongoing COVID-19 media reporting. However, messaging should be designed sensitively to legitimise seeking help for unusual or persistent symptoms, without causing undue distress.
Clear, consistent information from a trusted source is needed to encourage confidence in contacting the GP promptly, explain the changes to GP practice procedures and what to expect. This would also help alleviate worries about NHS capacity and infection control in hospital settings.
Ultimately, evaluation of campaign activity will be key, to ensure that it reaches the intended audiences, delivers its objectives, and does not exacerbate inequalities.
Methods
These results are based on a population-based sample of N=7,543 UK adults aged 18+ recruited online between August and September 2020. Two online surveys were conducted in parallel, the COVID-19 Health and Help-Seeking Behaviour Study (CABS) and the Cancer Research UK (CRUK) COVID-19 Cancer Awareness Measure (COVID-CAM). Qualitative interviews were conducted with 30 participants. Further results and methodology can be found in our policy briefing report.
This work was conducted in collaboration with a research team led by Prof Kate Brain (Cardiff University) with funding from UK Research and Innovation. See more on the wider study