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NHS England gives GPs until Monday to review patients who should be shielding

NHS England has given GP practices a deadline of Easter Monday to review lists of patients who should be ‘shielding’ from coronavirus (Covid-19). 

NHS England said it has now finished sending letters to patients that it has centrally identified, and IT system suppliers are updating patient records to reflect this – putting a flag against those patients that have been contacted.

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 new deadline comes almost three weeks after NHS England started the process, which should see a cohort of around 1.5m of the country’s most vulnerable patients told to avoid leaving their house for 12 weeks.

A bulletin to GP practices, sent yesterday evening, said: ‘So that all highest risk patients are both identified and able to register for Government support, please can you complete the review of your patient records by the end of Monday 13 April if you already have the flags in place.’

Practices will be sent a letter outlining how to access these flags, it added.

But NHS England clarified that GPs will not need to have contacted outstanding patients by Monday.

NHS England director of primary care Dr Nikita Kanani told Pulse: ‘This is just to check if the lists are there, not to have completed all the work.’

The list of patients who should shield includes organ transplant recipients, those undergoing cancer treatment and those with certain underlying health conditions such as severe asthma and COPD.

NHS England was to send a standard letter to these patients asking them to stay at home at all times and avoid any face-to-face contact.

But Pulse reported earlier this week that NHS England was still processing primary care data and adding to the list. 

At the time, NHS England asked practices to wait until it had completed its process before searching for flags in the IT systems and conducting their search for missed-off patients.

This week, GPs were further asked to set up a dedicated home-visiting team for ‘shielded’ patients. NHS England said the team should comprise of practice staff who has not been exposed to Covid-19-symptomatic patients ‘if possible’.

Note: This article was updated at 13.20 on 9 April to include a clarification from NHS England director of primary care Dr Nikita Kanani.

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