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New shielding risk algorithm delayed as experts criticise ‘unclear’ Government guidance


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The Department of Health and Social Care says it is still working to develop a risk prediction tool for GPs to determine which patients are most at risk from Covid-19.

It comes as the Government issued updated guidance for clinically extremely vulnerable patients advising them to take precautions depending on what ‘tier’ their local area is at.

Those in the highest risk areas may still be told to adopt formal shielding measures in the future based on advice from local public health experts but only for a limited period of time, the DHSC said – and this has not yet happened anywhere to date.

In June a new risk prediction model was commissioned by the chief medical officer so GPs could assess risk of serious illness or death from Covid-19 based on factors such as age, sex, ethnicity, deprivation, smoking status, body mass index, pre-existing medical conditions and current medications.

In a GP webinar in the summer the DHSC said that the implementation of the new risk calculator was ‘still being finalised’ with NHS Digital but with a view to having it embedded in GP systems ‘probably by September’.

A DHSC spokesperson confirmed to Pulse that development of the risk tool was ongoing.

Experts have previously warned that patients with diabetes, hypertension and cardiovascular disease should be added to the list of patients who may be asked to shield during a second Covid-19 spike.

The current list of clinically extremely vulnerable patients is the same as during lockdown and includes patients with severe respiratory disease and those receiving treatment for cancer.

In response to the updated guidance on shielding, charities have warned that people who fall into the clinically extremely vulnerable category need need more clarity on what exactly they should be doing as well as financial support if they can’t work from home.

Sarah MacFadyen, Head of Policy at Asthma UK and the British Lung Foundation, said there was lack of detail and timelines in the guidance.

‘We are told again today that people who are defined as clinically extremely vulnerable are at very high risk of severe illness from Covid-19.  

‘Yet it’s not clear how they will be able to access the support they need to be able to feed themselves and get access to vital medicines, particularly if help is not coming from local authorities or they are not eligible for benefits.’

Professor Azeem Majeed, professor of primary care at Imperial College London said: ‘It’s essential that people in vulnerable groups have clear advice so that they can reduce their risks from Covid-19.’

He added that even when a risk score was published it may not be accurate for individual patients. 

‘In the absence of clear government guidance and because of the limitations of any risk calculator that is published, people in vulnerable groups will need to make their own decisions.’

He said he advised patients to minimise their contacts but that did create a dilemma for people whose occupation does not allow this, such as people working in teaching, retail, or public transport.

A Department of Health and Social Care spokesperson said that shielding had been difficult for many people and the updated guidance was tailored to the Local Covid Alert Level in their area.

‘Shielding may only be reintroduced in the future in some of the worst affected areas, but there are currently no areas where shielding advice is in place.

‘Everyone is advised to work from home where possible, unless shielding advice is in place, but all workplaces should be Covid-secure. If anyone has concerns, they can raise them with their workplace union, local authority or the Health and Safety Executive, who will take action.’

READERS' COMMENTS [3]

Andrew Barber 19 October, 2020 11:07 am

When will they learn…. algorithms don’t work.

The Prime Minister 19 October, 2020 11:59 am

This is a waste of time and resources….

Turn out The lights 19 October, 2020 12:19 pm

?The Government