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The waiting game

NHS England director apologises for handling of shielded patient lists

NHS England's director of primary care has apologised to GPs for the organisation's handling of the issue of patients on GP lists who should be shielding themselves from Covid-19 infection.

Speaking in a live webinar on Thursday evening, Dr Nikita Kanani admitted the process has been 'really frustrating' for GPs and said she was 'very happy to apologise'.

This comes after GPs were given several tight deadlines for fact checking and amending lists of patients most vulnerable to risks of complications if they contract coronavirus.

NHS England was supposed to send these patients a letter with shielding advice and add them to a central list making them eligible for support services such as food drop-offs.

However, many were missed off the list, some received a letter in error and a number of patients have presented to GP practices after self-identifying as patients who should be on the list.

Dr Kanani said: 'On the shielding [there are] some comments about both the deadline and an apology. I'm very happy to apologise. It's been really frustrating and I'm sorry about that. 

'I hope that we can get the processes better. There are lots of agencies involved and we must get it right. My apologies, for what that is worth.'

Dr Kanani went on to explain why GPs were given a tight deadline of just a few days to check lists last weekend.

She said: 'I really do recognise that you've been waiting to do something then all of a sudden there was a deadline.

'Once we had a way with NHS Digital and the CMO's office to get the codes to practices, knowing that some people had already been shielding and might not have got any support at all and might therefore be vulnerable, we needed to make sure those people were getting the support they needed.'

'Thank you for going through those lists on a very very tight deadline which I know was difficult, but so hard to avoid because what it meant was patients could get the support that they need,' Dr Kanani further told GPs.

GPs were told from the start that NHS England expected to miss off a number of patients who should be shielding due to IT systems not being sophisticated enough to flag them all, which meant GPs would need to review lists.

But the checking process is still ongoing, three weeks after NHS England started the process that should have informed some 1.5m of the country's most vulnerable patients that they must avoid leaving their house for 12 weeks.

'People have said "I wish we could have just done the searches ourselves". I think at the very beginning we wanted to nationally help by getting the searches done and I guess we're trying to learn and do this as well as we can,' Dr Kanani said.

The next step in the process is GPs further reviewing those who had self-identified as being at clinical risk, which GPs had been asked to complete by Monday next week but the deadline for which has now been extended to the 28 April.

Dr Kanani said: 'They will be fewer in number because most of those patients you will already have found through your original searches or through the searches your system suppliers constructed. I envisage that at about a 10,000 practice list to be about 20 patients at the very most.'

Patients who have been asked to shield to avoid coronavirus

1. Solid organ transplant recipients

2. People with specific cancers

• People with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer

• People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment

• People having immunotherapy or other continuing antibody treatments for cancer

• People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors.

• People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs.

3. People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD

4. People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell disease)

5. People on immunosuppression therapies sufficient to significantly increase risk of infection

6. People who are pregnant with significant heart disease, congenital or acquired

Source: NHS England

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  • nikki kanani mar2019v2

Readers' comments (35)

  • Has anyone (or everyone) had their list of people that self-reported as high risk?

    We haven't had anything through and we were told it would be with us by today....

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  • National Hopeless Service

    This was a complex process that was never going to be perfect but what has angered my colleagues and I was the demand that it must be done by a certain date(s). This constant, pointless and infuriating micromanagement by CCG and NHSE has got to stop.

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  • Vinci Ho

    You see
    My English is always poor , enlighten me please .
    What is the difference between ‘ very happy to apologise’ and ‘very sincerely apologise’?
    And what about these words :
    Factitious
    Fatuous
    Feckless
    What do they mean , by the way ?

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  • Your apology is so not accepted. NHSE have adopted an attitude of micromanaging and bullying GPs for years. The relationship is done, the loyalty is done and the trust has long gone. We do our best for our patients, but will view NHSE as a sinister organisation with political objectives, not patient orientated ones. And this is why instead of a batch of GPs is their late 50s retiring from partnerships prematurely, you will see the same from GPs in their early 50s or late 40s, once this crisis has abated.

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  • Only an organisation so unwilling to listen, so utterly out of touch with the frontline and the practical realities of the situation could have made such obvious, fundamental errors.
    Real shame.
    At least some awareness here of their ample failings, which is very rarely, if ever apparent.
    I do hope this doesn't now herald endless acknowledgements of the problems and shortcomings - actual solutions are probably better at this time.

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  • ...and still no lists of those who have self identified to NHSE as high risk over the last 3-4 weeks. We were told the lists would be sent to us by today and should all be reviewed by a GP by the 20th. Now, I hear, they might appear at some point next week. Why?? I'm running out of excuses to tell patients. Embarrassing.

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  • These unilateral contract changes should not be agreed. It is pure abuse. The BMA should act.

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  • Shielding list and self reporting was a sensible idea executed appallingly.

    What started as joint statement in March involving the RCGP rolled on for several weeks with missed deadlines, constant change in criteria (and because of this, further confusion as charitable bodies published more criteria for vulnerability into the void left by NHSE) and is now still ongoing with more delay in identification of self vulnerability.

    Apologies are absolutely appropriate but the competence of those leading this process must be questioned.

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  • This crisis has revealed to us the fundamental pointlessness of some of GPs’ “governing” institutions. Local and national response has been inadequate and leadership entirely lacking. Once again it’s been down to GPs and their membership organisations to sort things out. We need to look carefully at the validity of some of these structures and really question their entire purpose when this is all done.

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  • AND SO THE WORKFORCE WILL MEEKLY ROLL OVER AND DO NOTHING AGAIN

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