Performance of Brazilian and English PHC during the COVID-19 pandemic: A scoping review

Abstract

This study aimed to map the available evidence on the performance of Primary Health Care (PHC) in the Brazilian Unified Health System (SUS), compared to the National Health Service (NHS) in England, focusing on the work process during the COVID-19 pandemic, as well as to identify knowledge gaps. A scoping review was conducted, based on the JBI methodology, with searches in the PubMed, LILACS, Scopus, Cinahl, Embase, and Web of Science databases, in June 2024. Studies in Portuguese, English and Spanish were included, according to the PCC (Population, Concept and Context) strategy. Study selection was conducted by three reviewers, with the support of EndNote and Rayyan software. Overall, 34 studies were analyzed. The findings indicate that the pandemic significantly affected the PHC work process. In both systems, priority was given to caring for patients with respiratory symptoms, reducing routine activities and de-characterizing PHC attributes. In the NHS, the centrality of GPs, expansion of telehealth, and greater structural capacity stood out; in SUS, multi-professional action was limited by technological weaknesses and lack of national coordination. It was also noted a lack of studies on Ambulatory Care Sensitive Conditions and health financing, indicating the need for future investigations exploring the effects of the pandemic from a comparative perspective.