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NHS England director apologises for handling of shielded patient lists

NHS England’s director of primary care has apologised to GPs for the organisation’s handling of the issue of patients on GP lists who should be shielding themselves from Covid-19 infection.

Speaking in a live webinar on Thursday evening, Dr Nikita Kanani admitted the process has been ‘really frustrating’ for GPs and said she was ‘very happy to apologise’.

This comes after GPs were given several tight deadlines for fact checking and amending lists of patients most vulnerable to risks of complications if they contract coronavirus.

NHS England was supposed to send these patients a letter with shielding advice and add them to a central list making them eligible for support services such as food drop-offs.

However, many were missed off the list, some received a letter in error and a number of patients have presented to GP practices after self-identifying as patients who should be on the list.

Dr Kanani said: ‘On the shielding [there are] some comments about both the deadline and an apology. I’m very happy to apologise. It’s been really frustrating and I’m sorry about that. 

‘I hope that we can get the processes better. There are lots of agencies involved and we must get it right. My apologies, for what that is worth.’

Dr Kanani went on to explain why GPs were given a tight deadline of just a few days to check lists last weekend.

She said: ‘I really do recognise that you’ve been waiting to do something then all of a sudden there was a deadline.

‘Once we had a way with NHS Digital and the CMO’s office to get the codes to practices, knowing that some people had already been shielding and might not have got any support at all and might therefore be vulnerable, we needed to make sure those people were getting the support they needed.’

‘Thank you for going through those lists on a very very tight deadline which I know was difficult, but so hard to avoid because what it meant was patients could get the support that they need,’ Dr Kanani further told GPs.

GPs were told from the start that NHS England expected to miss off a number of patients who should be shielding due to IT systems not being sophisticated enough to flag them all, which meant GPs would need to review lists.

But the checking process is still ongoing, three weeks after NHS England started the process that should have informed some 1.5m of the country’s most vulnerable patients that they must avoid leaving their house for 12 weeks.

‘People have said “I wish we could have just done the searches ourselves”. I think at the very beginning we wanted to nationally help by getting the searches done and I guess we’re trying to learn and do this as well as we can,’ Dr Kanani said.

The next step in the process is GPs further reviewing those who had self-identified as being at clinical risk, which GPs had been asked to complete by Monday next week but the deadline for which has now been extended to the 28 April.

Dr Kanani said: ‘They will be fewer in number because most of those patients you will already have found through your original searches or through the searches your system suppliers constructed. I envisage that at about a 10,000 practice list to be about 20 patients at the very most.’

Patients who have been asked to shield to avoid coronavirus

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