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Shielding patients removed from list 'without GP consultation'

Patients who are shielding from coronavirus (Covid-19) are being removed from the list without GPs being notified or having spoken with them first, according to charities.

People with forms of cancer, liver disease and severe asthma are thought to be among those affected. 

Asthma UK said patients with severe asthma and lung disease had been told they had been dropped from the shielding list, without their GP having been notified.

It described the situation as an 'utter mess' and said it is seeking 'urgent clarification' from the NHS.

The British Liver Trust also said some patients had been sent a text by the Government's shielding service telling them to stop shielding, yet their doctors had not had a chance to speak with them first.

The charity said it believed there has been a 'blip' with the texting service, because the messages should not be sent out until the patient has consulted with their doctor.

It has complained to the Department of Health and Social Care and said that it is advising patients who receive a text to wait until they have spoken with their clinician before taking any action.

NHS England's medical director of primary care Dr Nikki Kanani said on Twitter that the organisation was unaware of the issue but is looking into it further. 

As of last week, 2.2 million people in the UK had been identified as being clinically extremely vulnerable and therefore told to shield themselves against the virus, by not leaving their home for 12 weeks, until at least 30 June.

Collectively, GPs have removed more than 107,000 patients from the shielding list so far who were thought to be wrongly added in the first place,

Commenting on the revelation that patients are being told to stop shielding, without having spoken to their doctor first, Vanessa Hebditch, from the British Liver Trust, told the Guardian: 'The Government has said that individual doctors can use their clinical judgment and take people off the shielding list. 

'I’ve had assurance from the Department of Health and Social Care that nobody should have received a text as the first piece of communication. Their consultant should have written to them or rung them. 

'Some people who have received this message haven’t had those conversations, so clearly this was a blip. Our advice, if you do receive a text, is to continue to shield until you have received direct advice from your own clinician.'

In a statement, Asthma UK saidWe have heard from people with severe asthma and lung disease who have been alarmed about receiving official text messages with no explanation, dropping them from shielding. Some are saying their GP had also not been told. This is an utter mess.

We are requesting urgent clarification from the NHS and call for patients and charities who provide advice and support to be involved in planning any future communication. We also strongly recommend that people’s GPs are kept informed about what their patients are being sent.’

In a tweet to GPs concerned about not being told when patients are removed from shielded lists, NHS England's Dr Kanani said: 'We are not aware of this but are trying to find out more.'

A Government spokesperson said: ‘The Government is committed to supporting the clinically extremely vulnerable and all decisions about whether someone should shield are clinically led.

‘In some cases, clinicians have advised that a patient no longer needs to shield themselves from coronavirus. Where this is the case, the person will be informed by their clinician that they are not on the shielded patient list. NHS England has issued guidance to clinicians to enable them to communicate this.

‘Those advised that they no longer need to shield may still access forms of support including the NHS Volunteers network, and will retain their supermarket priority delivery slots.’

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Readers' comments (6)

  • What a complete and utter farce. I bet this ends up as more GP work as they ask us to review them all. Again.

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  • I read about this in a Guardian article last night - we seem to be the last to know anything. Save with 'test and track'.
    Shielding has been totally mismanaged.
    Why they did Shielding lists centrally rather that using our local searches and knowledge is beyond me.
    Involving GPs from the outset would have been far more accurate, would have saved a lot of time & patient distress - and also all our collective time dealing with unnecessary inquiries & mopping up the mess

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  • Rogue1

    Why are the RCGP, BMKA and Gov.uk shielding lists all got different clinical criteria. Even now almost 3months in?
    Says a lot about how well the process is being managed!

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  • Vinci Ho

    NHS England's Dr Kanani said: 'We are not aware of this but are trying to find out more.'

    Well , at least you were honest , in contrast to the so called ‘government spokesmen’ ( don’t even know whether that is a human being or simply a robotic recording ).
    Otherwise , this is reminiscent of the sensitivity, awareness , in touch of the real world and of course , competence of this government through last 2 months .
    How the history will judge , I leave that to your own device , Nickki...........

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  • I have massively struggled to decide who should or shouldn't be shielding. Initially I tried using common sense and clinical judgement. This gave way to acquiescing to belligerent patients.

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  • Parties breweries organisation

    When will people realise life is a risk from conception to death and that you cant defeat nature.

    Are the excess deaths really all Covid -19 we won't know for several years. Listen to David Spiegelhalter's excellent interviews on R4 about the stats

    Some personal research

    The 1919-2009 figures are drawn from government papers

    1918 Spanish flu several waves 25% of the population had symptoms. 4% needed (got) hospital admission. 2% died

    1957 Influenza one wave 30% of the population got symptoms (75% in my house) 0.55% hospitalised and 0.15% deaths

    1968 HK influenza 35% of the population got it 0.55% hospitalised 0.3% deaths (ran through my prep school of 120 in 3 days)

    2009 H1N1 Less than 5% needed treatment and there were few deaths.. circa 500 in UK

    2020 C-19 Government says 26097 deaths = 38.4 per 100,000 population implied population therefore just shy of 68 million as at 28 April. Early government estimate was 0.1% of the population would get C19 but some estimates are upto 4 million infected at 4 million infected that would be a 0.00652% death rate

    Remember in 1957 and 1968 you had a sick note physically issued at Day 1 of sickness. I remember my GP, a family friend telling me when I was considering becoming a GP, that he did 20/25 visits a day during the flu outbreaks really just to issue certificates but the point is that these numbers were eyeballed by a clinician at the time.

    In 2020 with self-certification and no widespread current test of exposure/infection we really don’t know what the real prevalence is but if it is as high as 4 million people then the infection rate is just under 6% !

    To be at the 1968 HK levels would imply 23.8 million infected. Given we were slow off the mark with lockdown we have no idea but OK at current death rates it would mean 155,000 deaths if that were the case but how many are actually simply the terminal event in very longstanding chronic illness which of itself was not survivable in 1968 or might not have survived next winters flu aka the old persons friend?

    I get the point about keeping the peak down so the ITU can cope

    So is the continuation of this lockdown a party political ploy to detract from the fact that government have ignored professional advice for many years at the altar of austerity/ the profession is not to be trusted post 1990?

    Is it because politicians can no longer peddle the comforting thought to a risk averse unthinking public (that has never seen a scale of death like our antecedents) that they can insulate the public from the fact that life is a risk from conception to death?

    Is it because politicians are frightened of having to admit the truth for once that they are powerless in the grand scale of things?

    Many colleagues have given their lives in this C-19 outbreak because of insufficient PPE caused by Treasury parsimony over the years and that is not right, but if we don’t go back to work soon there won’t be an economy worthy of the name able to deliver a tax take to support the NHS we all want. A well functioning, properly resourced NHS would be a fitting, if inadequate, tribute for their ultimate sacrifice.

    Are we trying to defeat nature rather than rub along with it and in the words of the Prof of Anatomy at Sheffield, Day1, Lecture 1 “You cannot defeat nature.”

    Is this shielding all about being seen to "do" something by politicians

    Just saying....... DEBATE

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