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GPs go forth

GPs asked to review 1.5 million patients most at risk from coronavirus

GPs should review 1.5 million patients identified by NHS England as the most vulnerable to the coronavirus (Covid-19).

NHS England will send a standard letter to these patients asking them to stay at home at all times and avoid any face-to-face contact for at least 12 weeks.

GPs will be able to access a report on which patients will be contacted with specific advice from today - with NHS England directing GPs to review the list and provide additional support to patients.

The patients, who are at 'the highest risk of severe illness that would require hospitalisation from coronavirus', include those who have had an organ transplant; people with specific cancers; people with severe respiratory conditions; people with rare diseases; people on immunosuppression therapies; and pregnant women with significant heart disease.

NHS England said in a letter to GPs: 'We ask that you review this report for accuracy and, where any of these patients have dementia, a learning disability or autism, that you provide appropriate additional support to them to ensure they continue receiving access to care.'

GPs can identify the patients contacted by NHS England through an 'at high risk' indicator code that has been applied to each patient record by the practice's clinical system supplier.

'Your supplier will inform you of the code they have used, which should be treated as temporary until a definitive list of Covid-19 "at risk" SNOMED codes is released,' NHS England said.

'Your GP System supplier will also provide a report that will list those patients that have been centrally identified as being at high risk. You should have this by 23 March.'

But NHS England said central datasets were 'not sophisticated enough to identify all categories of patients who should be included in the vulnerable groups list' and it was therefore calling on GPs and specialist consultants to help identify patients who may have been missed.

The letter said: 'We appreciate this is a complex task requiring difficult judgements, and we ask for your help, as the GP central to the care of these patients, in achieving this.'

In a separate letter, England's chief medical officer Professor Chris Whitty asked GPs to add to the list of most vulnerable patients using their 'clinical judgement'.

The letter said: 'You may know of specific additional patients in your practice who you think are particularly high risk.

'On the other hand there are a limited number of people that we can shield effectively or for whom this highly socially isolating measure would be proportionate on health grounds; many patients who fulfil the criteria may after discussion with you prefer not to be placed under such strict isolation for what will be a prolonged period.' 

Patients who will be contacted by NHS England

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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Readers' comments (26)

  • ItSaDoGsLiFe

    Just what we all need, an 18 page document from nhs england giving us more tasks to do.

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  • ItSaDoGsLiFe

    Correction, 13 page, but you get my point.

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  • Where's the PPE? Sending GPs in is like opening the door to invite the virus in.

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  • Time to regret the decimation of the primary care workforce by the collective efforts of the CQC, GMC and HMG, so that we are now woefully under-staffed to deal with this crisis. That is shameful.
    And the fact that once we have passed this peak, all those fugitives from the frontline and sadistic sycophants will take up their cudgels against the GPs once again and resume the torture. That's shameful.
    Watch it happen...

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  • i thought i saw a light at the end of the tunnel.............but it was some twat from the nhs with a torch bringing me more work !

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  • I am unable to take up a post in Australia ( for obvious reasons ) and therefore I find myself unemployed GP in UK .Spent the morning phoning Locum agencies who have NOT had any requests for Locum GP to take up tele consults . COVID Assess Centres or anything towards manning for the great influx of patients expected in the next few days.
    Just had a email from My local Health Board about the expected COVID assess centre. This w was supposed to satrt today Monday 23March and is to have dedicated staff ( with appropriate PPE ) keeping these patients away from GP surgeries and A+E.
    It is NOT opening due to lack of staff. I was just about to phone and say I was available when I realised they are relying on GP practices to free up their regular GP's for this 24/7 Centre.
    WTF they are getting GP already in post to manpower this as part of their GMS contract / sessional work .They are already snowed under and what about the chance of cross infection to other Surgery patients and their own family as they will be heavily exposed to coronavirus .
    Australia and New Zealand are also doing the same but ar recruiting and paying docore specifically and lodging them in hotels for the duration.

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  • '....GPs will be able to access a report on which patients will be contacted with specific advice from today - with NHS England directing GPs to review the list and provide additional support to patients...' Extra support, what would that look like exactly, when youve already got 5 out of 11 GPs inn isolation (as we have), and an imminent avalanche of home visitimg and COVID centre overspill. They should isolate as advised and ring us if theyre ill..WTF else can we do.

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  • Why is there still no system of self reporting Covid 19 even in the absence of testing? Why just guess/model prevalence? How can any sensible response and planning proceed without this basic information?

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  • Is this letter actually wise or sensible. I find it very unlikely many or any of the very high risk patients don’t already know it. Beware the unspoken message you send to those who don’t get the letter and how they may then take social distancing less seriously. To me this is just doing something for the sake of it and I suspect will be counterproductive

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  • What is an "asthma rescue pack"? I have had a load of punters ringing up demandind their rescue pack. I think expecting a Selfridges style gift pack with inhalers, steroids and antibiotics. Anyone any clues about this?

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