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.’