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GPs go forth

NHS England asks GPs to review self-identified shielded patients from this week

Patients who have assessed themselves as being in the highest clinical risk group for coronavirus, and therefore needing to shield, will need to be reviewed by GPs from this week, NHS England has said.

Practices will this week be sent a list of patients who assigned themselves to the most clinically vulnerable group by signing up on the Government website.

The majority of patients who require shielding - which involves quaranting themselves for 12 weeks - should be identified by NHS England, with some help from GPs and hospital consultants.

But an additional route, allowing patients to directly add themselves to a Government list via its website, was also set up in case any patients were missed.

In an update about how GPs should care for shielded patients that was published on 3 April, NHS England said: 'We ask that you review this list and consider if any of them should be included in the highest clinical risk group.

'Please send a letter to any you consider to be at highest clinical risk and add a flag to their record. You may wish to contact the people who self-referred and who you consider to not be the highest clinical risk group to confirm that they do not need to shield.'

Meanwhile, many patients at the highest risk of coronavirus have still not yet received a letter from NHS England notifying them to shield themselves, health service bosses have admitted.

The Government originally said NHS England would write to extremely vulnerable patients by 29 March.

But since then GPs have reported being contacted by patients who are concerned they fall into the highest risk category, but have not received a letter from NHS England.

NHS England said it had sent its letters out to the majority of patients it had identified as being high risk, but that the second phase – involving NHS England using primary care data to add more patients to its list of clinically most vulnerable patients – was ongoing.

It advised GPs to wait until all the NHS England letters had been sent out – which will be flagged on GPs’ digital patient records – before they themselves conduct a further search of their patients to see if any others have been missed off the list.

During a webinar hosted by NHS England last night, the organisation’s director of strategy Emily Hough said the process of sending out letters ‘hasn’t been as streamlined as we would have liked’.

She said: ‘We are trying to identify the majority of patients [who are at clinically the highest risk] through a national search on patient data but we know that there will be additions that will need to be added locally both by secondary care clinicians and yourselves.

The second phase is currently in progress and that is using primary care data to update that list based on [the criteria agreed by] the CMO. The patients identified through this route will also be centrally flagged in GP IT systems and will receive a central letter.

‘That will cover another smaller but reasonable cohort of patients. We’re hoping that those letters will go out in the next few days and that will then be updated with the flags in the GP records.’

Referring to the third phase of the process, in which GPs are expected to contact additional patients who they consider to be high risk, she added: ‘At the moment we’ve asked that you wait to hear from your IT system supplier with the updated list and the guidance.

‘We know that some people have suggested running searches and we think it would be best if you wait to get that report from your IT system provider and use that to cross check your list.’

In further information on caring for shielded patients, released today, NHS England said: 'Once phase three is underway, your GP system supplier will inform you of which codes to add to your GP system to flag these additional patients.'

The NHS England document also said that patients undergoing private care for cancer may need to be identified and added to the list of high-risk patients by their GP.

NHS England’s director of primary care, Dr Nikita Kanani, said during the webinar that national efforts were being drawn up to tell patients not to contact their GP if they hadn’t received a letter yet.

She said: ‘We are trying to get national comms out to reassure patients that they might not have been contacted yet and not to be contacting their practice.’

Related images

  • letter getty images 863698402

Readers' comments (12)

  • It's a dog's dinner. 10 days ago we were informed that Group 4 patients were to be identified by GPs and there was even a downloadable letter to send to them. Now we are told not to do any searches and NHSE are doing further searches in our records but without our involvement. No information about which codes have been searched for already. Could have been done a lot better if NHSE engaged with us in the first place.

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  • The response of NHS England has been woefully inadequate and essentially demonstrates the incompetence of leaders who essentially have put all NHS workers at risk of harm or death. Furthermore,PCNs have failed to provide any stability or direction or robustness to the system and we are seeing PCN funds being sidelined for the few. Addtionally, we are seeing are PCN Clinical Directors directing their resources to their own practices in many cases these being the larger practices within the PCN. PCN clinical directors continue to be paid £2000 to £3000 per month for work which is currently not being done . Perhaps these fees should be returned to the NHS for a more useful purpose?

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  • i got my letter today - dated 24/3/20, that's almost two weeks ago. it seems the welsh nhs is just as bad - probably worse !i've been stuch in the house for 15 days now !!

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  • Stay at home. A simple message. How much more pretend "shielding" can one do short of putting a mask and goggles on them?

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  • Its a fair point Truth Finder... The only issue I guess is for those who think they are high risk and need to be told they arent, and those who dont know/think they are and need to be reminded/advised. Apart from a letter to the latter and a quiet word with the former when they at some point claim they are, what else frankly can we do. The real capacity killer is going to come when we're officially told the shielded patients can only be seen (if needing F2F) in their own home..(which seems to be implied in todays NHSE update)

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  • Visit nobody - we are the only nation which provides all care services to patients in the home, free, unlimited - and now with unlimited risk. Or, ask yourself if your visit is worth you and your family dying for the dying patient.

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  • Letters. Hmmm. Not the most reliable means of communication at the moment. The postal service is overwhelmed. May be why patients haven’t had these letters yet.

    I haven’t had Boris’s letter yet...

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  • Review what exactly? In a few months, we will be standing by the shredder giggling to ourselves. Still under their iron fist, covered in candy floss at present.

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  • piss up and brewery are words that spring to mind here

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  • DrRubbishBin

    I really don't see the point of all this..smells of people with nothing much to do trying to look busy and important..'oh we'll write to GPs and tell them to do stuff...thank God we're here, at least someone is writing letters to GPs telling them to do stuff during the countries hour of need.' Cause we all know the one thing we are short of just now is people to tell other people what work they need to be doing. Thanks guys, keep those helpful and instructive letters coming

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