Impact of Virtual Maternity Care During COVID-19 on NHS Costs

A study from King's College London reveals that virtual maternity care during COVID-19 increased NHS costs due to more follow-up appointments, highlighting disparities among ethnic groups and underlying long-term trends.
Recent research indicates that the shift to virtual maternity care during the COVID-19 pandemic has contributed to increased healthcare expenses for the NHS. A comprehensive study conducted by King's College London analyzed data from over 37,000 pregnancies in South London, examining changes in care patterns and costs across antenatal, emergency, general practitioner, and mental health services during the pandemic period.
The adoption of virtual appointments was initially implemented to maintain maternal care while minimizing infection risks. However, findings reveal that virtual consultations often led to additional in-person visits, especially when physical examinations were necessary to address evolving pregnancy concerns. Notably, the study found an approximate increase of £7 in pregnancy costs for every 1% rise in virtual appointments, resulting in an estimated extra expenditure of about £837,310 for the NHS due to increased virtual care.
Further analysis showed that the total number of antenatal appointments grew during the pandemic, possibly indicating that virtual visits served as preliminary assessments, prompting further in-person follow-ups when issues remained unresolved. Interestingly, maternity costs temporarily declined at the start and end of lockdowns—by about 4% and 7.6%, respectively—yet overall costs continued to rise gradually over the long term. During lockdowns, each pregnancy was approximately £307 more expensive, with costs increasing by £471 after restrictions eased, reflecting ongoing economic pressures and pre-existing trends.
The study also highlighted disparities across different ethnic groups. It found that NHS maternity costs for Black and Asian women were higher at the start of and following lockdowns compared to white women, with Asian women experiencing continued increases post-lockdown. These variations underscore the pandemic's differential impact on minority ethnic groups.
Data was sourced from electronic health records stored in the Early Life Cross-Linkage in Research (eLIXIR-BiSL) platform, which consolidates information from three NHS hospital trusts in South London, covering the period from October 2018 to April 2023.
Overall, while virtual maternity care helped sustain access during the pandemic, it also contributed to rising costs, partly due to increased follow-up needs. These insights can inform future strategies for delivering cost-effective maternity services, especially in times of health crises.
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