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The waiting game

GPs should contact all shielded patients as a 'follow-up' to letter, says NHS

Practices should contact all of their patients who are shielding from coronavirus (Covid-19) as a 'follow-up' to the NHS letter notifying them to stay at home for 12 weeks, NHS England has said.

During this follow-up conversation, GPs should discuss what shielding means and any changes to the patient's ongoing care and treatment - including home visiting.

GPs should also confirm the patient has an arrangement in place for receiving medications, and also check they are aware of the Government's support package, as part of the discussion.

NHS England laid out these latest instructions in an email bulletin sent to practices last night, which also stressed home visits 'remain the preferred option where capacity allows' to protect the health of shielded patients.

During a webinar last night, NHS England's medical director for primary care, Dr Nikita Kanani, acknowledged the 'majority' of practices are already following up with shielded patients, but reminded others to ensure they do the same.

The bulletin said that the 'majority’ of the work to establish which patients should be on the shielded list is now ‘near completion’. 

It added: 'Where you have not already done so, we are requesting that all practices make sure that they have contacted all the people on their patient list who are shielding as a follow-up to the letter.

'These conversations should: (a) discuss what shielding means, (b) describe any changes to their ongoing care and treatment, including home visiting wherever this is clinically needed (c) confirm they have an arrangement in place for receiving their medications and (d) check that they are aware of the Government support offer.’

Speaking in a live webinar last night, NHS England's Dr Kanani told GPs to ’make sure you have checked on [shielded] patients’, although she added that the ‘majority’ of practices are already doing this.

She said: 'In our practice, one of our colleagues has just worked their way through the list, called them and checked in on them to make sure that they’re okay and they understand what’s going on.

'If you haven’t, please do that, it’s really important to make sure that these patients aren’t sat at home in a particularly vulnerable position because they haven’t got contact with anyone.’

Earlier this month, GPs were asked to set up a dedicated home-visiting team for shielded patients - with staff who had not been exposed to patients with virus symptoms ‘if possible’.

The bulletin added that patients should not be brought into practice premises unless a designated site has been set up, where patients with Covid-19 symptoms are not seen.

It said: 'Home visits remain the preferred option where capacity allows to protect the health of shielded patients.’

Meanwhile, NHS England added that a further 79,000 individuals have been identified as requiring shielding ‘as records and coding have been updated’ and that letters and text messages are being sent to this group from today.

The bulletin said: 'Going forward, please review any new patients that contact you self-declaring to be clinically extremely vulnerable, adding any that – in your clinical opinion – meet the criteria to the list.'

It also reiterated that splenectomy patients should be included in the shielded patient list, despite earlier confusion over their inclusion.

NHS Digital will identify patients who have had a splenectomy and have been mistakenly removed from the list centrally from 29 April and will alert practices, who should then contact the patients to inform them of the error, it added.

It comes as the deadline for GPs to review the list of patients who have self-identified as requiring shielding was this week extended to the 28 April.

Dr Kanani apologised to GPs last week for NHS England's handling of the shielded patient list amid criticism over tight deadlines and delays to the checking process.

NHS Digital has also apologised for sending nearly 11,000 shielding letters to dead people in error.

Readers' comments (32)

  • Nope not doing this - they have made a monumental mess of this and we have spent enough time - we have contacted those who we felt it would make a difference - we need to collectively say enough is enough

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  • We can apologise ,as they did For sending letter to dead patients. Why patient can’t take some responsibility??

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  • Nope.
    Contact them for what reason? The letter they receive is pretty self explanatory. What does taking up precious GP time to arbitrarily contact them all achieve?

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  • Nope. Useless stunt and certainly not after the mess they've caused.

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  • 'If you haven’t, please do that, it’s really important to make sure that these patients aren’t sat at home in a particularly vulnerable position because they haven’t got contact with anyone"

    No Nikki, that's SOCIAL SERVICES you are thinking of. And the verb is "sitting", unless you personally sat them down. Jeez.

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  • The constantly changing shielding goalposts have caused unnecessary confusion and distress among patients and practices. I agree, enough is enough and if the correct message (despite the confusion) has not got to the appropriate patients yet, it never will.In fact the mismanagement of shielding by NHSE has added to the problem. In the early stages, we were asked to contact all patients at risk based on flu elegibility for shielding and we did. Then the goal posts changed to a more specific cohort needing shielding only with everyone else we had contact needing onky social distancing vigilance. Now I have to call all splenectomy patients who i have advised don't meet the criteria again to tell them they now do? Patients will think we are incompetent when it is quite obviously clear NHSE is the cause of this farce. Waste of time.

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  • Dear NHSE should I carry tea, biscuits or perhaps basket of weekly shopping for these shielded patients when I am doing their follow up as per your order........

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  • We have 700 shielded patients on our list. I don't think we'll be calling them all. As said above, the letter is self explanatory, if they want to discuss they can call us.

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  • Pradeep, although Easter is over and supermarkets have no more stock of cream eggs, you have to go get them. It’s now a mandatory requirement for you to go do that.

    While all you lazy and overpaid GPs are at it, make sure you do the patients’ plumbing, cooking, cleaning, haircuts, bills, laundry, and every whim and hearts desire for all the patients. Why? Because that’s the job of a GP. ¯\_(ツ)_/¯

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  • Dear NHS England,

    a period of silence on your part would be most welcome.

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