If virtual appointments are adding rather than replacing care, we need to consider how best to use them – especially in areas like maternity, where seeing a patient face-to-face is often essential.
Dr Marina Soley Bori, Lecturer in Health Economics in the School of Life Course & Population Sciences and co-author of the study.
10 July 2025
Virtual maternity care during COVID-19 pandemic linked to higher NHS costs
New research reveals that virtual maternity care during the COVID-19 pandemic may have driven increased use of subsequent care, raising overall maternity costs for the NHS.
The study from King’s College London examined data from over 37,000 pregnancies in South London and looked at how maternity care patterns, and associated costs to the NHS, changed across antenatal, emergency, GP and mental health services during the pandemic.
The use of virtual care was associated with an increase in pregnancy costs – around £7 more per person for every 1% increase in virtual appointments. The NHS incurred an additional cost of £837,310 due to the increase in virtual care compared to before the pandemic.
During the pandemic, virtual appointments were introduced to help maintain care access while reducing the risk of infection. However, the study found that remote consultations often led to additional in-person follow-up appointments, especially where physical examinations were needed to fully assess concerns.
The study found that the use of virtual maternity care also led to a rise in the total number of antenatal appointments, suggesting that some virtual appointments may have served as an extra step to triage patients who still needed face-to-face care. The researchers think that in some cases, patients may have felt their concerns were unresolved after virtual consultations, prompting them to request additional follow-ups.
Overall, analyses revealed that maternity costs dropped temporarily when the first lockdown began (by about 4%) and again when lockdown restrictions ended (by about 7.6%) compared to before the pandemic. However, over time, overall maternity costs continued to increase slowly. On average, each pregnancy was £307 more expensive during lockdowns, and £471 more expensive after restrictions were lifted, compared to pre-pandemic figures. These increases reflect longer-term, pre-pandemic patterns, alongside the unique pressures of the pandemic period.
The study also found some differences across ethnic groups, suggesting the pandemic affected minority ethnic women differently. NHS maternity costs for Black and Asian women were higher at the start of and after lockdowns than for White women. For Asian women, this trend continued post-lockdown.
The study used electronic health records from October 2018 to April 2023 from the Early Life Cross-Linkage in Research, Born in South London (eLIXIR-BiSL) platform, which combines data from three NHS hospital trusts in South London.
This research was part of the RESILIENT project, led by Professor Laura Magee at King’s College London, and funded by the National Institute for Health and Care Research (NIHR) and the Medical Research Council (MRC). The RESILIENT research team is now working to understand how virtual care delivery affects maternal health outcomes.
Read the full study in BMC Medicine.
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Lecturer in Health Economics
Professor of Women's Health