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All shielded patients should have named clinical lead, says NHS England



All patients who are shielding from coronavirus should have a named ‘lead co-ordinator’, according to the latest NHS England standard operating procedure for general practice.

The updated document said that the role can be ‘either in primary or secondary care’.

But GP leaders suggested the guidance was just ‘PR soundbites’ and advised that practices are not contractually obliged to follow it.

It comes as the 2.2 million patients who have been shielding from Covid-19 since March have been told they are allowed outside from today, in an ‘out of the blue’ announcement that was not communicated to GPs.

The nomination of a clinical lead is one of nine ‘key actions’ that general practices must take to support their shieling patients, according to the new standard operating procedure published on Friday.

It said: ‘Ensure a named, lead co-ordinator is in place, either in primary or secondary care.‘

The document added that practices must also ‘support patients with urgent medical needs’ – while acknowledging that shielded patients ‘may also need to contact their specialist consultant directly’.

Practices should ‘review and update personalised care plans and undertake any essential follow-up’, it said. 

Other actions include working with local mental health, learning disability and autism services to review shielded patients receiving care from them and supporting patient self-management.

But Kent LMC medical secretary Dr John Allingham told Pulse: ‘It makes no difference whatsoever but it fills the Government’s criteria. A lot of this is PR soundbites.’

Dr Allingham added that the nomination will likely be ‘fudged’ in the same way that named clinicians for care homes are CCG nurse leads or infection control leads rather than GPs ‘in many cases in Kent’.

Meanwhile, he advised practices that the standard operating procedure is ‘not a contractual obligation yet’ and cannot be enforced. 

All shielded patients should now register with the Government support website ‘whether or not they require additional support’, the document added.

NHS England reiterated that shielded patients requiring face-to-face assessment should receive a home visit ‘unless clinically indicated’ and ‘ideally by a dedicated team’.

Practices must make ‘at least one contact’ with all registered patients on the shielded list and ‘make every contact count’ as they deliver follow-up ‘as required’, it added.

Shielding patients – who were originally told to shield until 30 June – were told they could now go outside if following social distancing in an ‘out of the blue’ announcement on Saturday.

There have been numerous concerns that neither patients’ GPs – who had been asked to verify lists and manage patients’ clinical needs – nor commissioners seemed to have been informed or consulted ahead of the announcement, which comes as shielding guidance is relaxed from today.

And last week, health charities warned that individual patients were being removed from the shielding list, via a text message from the Government, without GPs being notified or given a chance to communicate with their patients first.

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