Will ‘the feeling of abandonment’ remain? Persisting impacts of the Covid-19 pandemic on rheumatology patients and clinicians

Melanie Sloan*, Rupert Harwood, Caroline Gordon, Michael Bosley, Elliott Lever, Rakesh Modi, Moira Blane, James Brimicombe, Colette Barrere, Lynn Holloway, Stephen Sutton, David D'Cruz

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review



To better understand rheumatology patient and clinician pandemic-related experiences, medical relationships and behaviours in order to help identify the persisting impacts of the COVID-19 pandemic and inform efforts to ameliorate the negative impacts and build upon the positive ones.


Rheumatology patients and clinicians completed surveys (patients n = 1543, clinicians n = 111) and interviews (patients n = 41, clinicians n = 32) between April 2021 and August 2021. A cohort (n = 139) of systemic autoimmune rheumatic disease patients was also followed up from March 2020 to April 2021. Analyses used sequential mixed methods. Pre-specified outcome measures included the Warwick–Edinburgh Mental wellbeing score (WEMWBS), satisfaction with care and healthcare behaviours.


We identified multiple ongoing pandemic-induced/increased barriers to receiving care. The percentage of patients agreeing they were medically supported reduced from 74.4% pre-pandemic to 39.7% during-pandemic. Ratings for medical support, medical security and trust were significantly (P <0.001) positively correlated with patient WEMWBS and healthcare behaviours, and decreased during the pandemic. Healthcare-seeking was reduced, potentially long-term, including from patients feeling ‘abandoned’ by clinicians, and a ‘burden’ from government messaging to protect the NHS. Blame and distrust were frequent, particularly between primary and secondary care, and towards the UK government, who <10% of clinicians felt had supported clinicians during the pandemic. Clinicians’ efforts were reported to be impeded by inefficient administration systems and chronic understaffing, suggestive of the pandemic having exposed and exacerbated existing healthcare system weaknesses.


Without concerted action—such as rebuilding trust, improved administrative systems and more support for clinicians—barriers to care and negative impacts of the pandemic on trust, medical relationships, medical security and patient help-seeking may persist in the longer term.

Original languageEnglish
Pages (from-to)3723–3736
Number of pages14
JournalRheumatology (Oxford, England)
Issue number9
Early online date6 Jan 2022
Publication statusPublished - Sept 2022


  • Covid-19 pandemic
  • Healthcare-systems
  • NHS
  • Rheumatology
  • chronic diseases
  • healthcare behaviours
  • medical security
  • mental health
  • patient-clinician interactions
  • telemedicine
  • trust


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