NHS Wales may identify any patients missing from the shielding list centrally rather than asking GP practices to run their own searches, according to the RCGP.
In England, GPs were given until last Tuesday to review patients that have been flagged by NHS England as being at the highest clinical risk from Covid-19 and to add any missed patients to this register.
However, an RCGP training module said that practices in Wales may only have to identify such patients on an ‘ad hoc’ basis.
It said: ‘Practices have not at this point been asked to run any computer searches to identify cases which have been missed.
‘NHS Wales is investigating the possibility of running searches like this centrally, adding patients to the list of those assessed as extremely vulnerable, and generating letters for these patients, if they have not already been identified in an ad hoc way by practices.’
The module added that GPs in Wales should provide patients they believe should be shielding or meet the criteria but who have not received a letter advising them to do so with a letter and flag this on their patient record.
It said: ‘If the patient has not received a letter, and they are either on the list that should have had one or you agree that they should shield, you can give them a specimen letter (with their name the practice stamp on it) and add the code 65Z.. Infectious disease prevention/control NOS to their record. This code will trigger their name being passed to the local authority for extra support.’
GPs should follow the same process for patients who are indicated by consultants as requiring shielding but have not received a letter if the GP ‘agrees with the consultant’s view’, the RCGP added.
Dr Phil White, chair of BMA Wales’ GP committee, confirmed to Pulse that GPs ‘certainly haven’t been asked to do a trawl’ of their records.
He said: ‘[There is] no policy for GPs to run searches, but if approached by people who think they should be on the list we can check in their records and issue a shielding letter if needed. We certainly haven’t been asked to do a trawl.’
However, the number of patients contacting practices in Wales is ‘dwindling’ as the central algorithm is being re-run by the Government, he added.
He said: ‘The Welsh Government has certainly been re-running the algorithm as they missed a few types of cases originally. So the shielding list has been added to week on week [and] as the algorithm has been re-run the numbers contacting practices is dwindling.
‘Curiously we have some patients who have received a letter and wonder why.’
‘Confusion arose’ between the two groups that require different levels of shielding – those over 70 with ‘simple-comorbidities’ who require ‘ordinary shielding’ and no letter, and those in specific groups advised to self-isolate for 12 weeks in ‘high-risk shielding’ – Dr White added.
Meanwhile, NHS Digital has apologised for sending nearly 11,000 shielding letters to dead people in error.
Four more conditions have now been added to the list of those requiring shielding from Covid-19, according to the training module.