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Renal dialysis patients added as shielding list reaches 1.85m patients



Renal dialysis patients are to be added to the list of people who require shielding from Covid-19 because they are extremely vulnerable to complications.

NHS England confirmed to GPs in a bulletin sent last night that the chief medical officer for England had made the update to the criteria for inclusion within the list.

It said GPs are ‘asked to note this update’ but ‘no further action is required’ by them, because they will be contacted by their hospital.

It comes as NHS Digital has now got 1.85 million patients on the shielding lists, as GPs are going through a final smaller cohort of patients who have self-identified as vulnerable. These may or may not get added to the list.

Initially, NHS England had said it expected some 1.5m patients to require shielding.

Renal units will now contact their patients and send them a letter notifying them to shield and the relevant NHS trust will then notify NHS Digital of the patients it has added to the list.

Separately, NHS England added that ‘a small group’ of new patients requiring shielding had been identified by national data and that these would be flagged on GP records ‘soon’ as letters are sent to patients this week.

NHS England asked GPs to contact these patients in the same way they have done for others on their practice’s shielded list.

It reminded GPs of the ongoing addition of new patients to the as they become sick, while others with ‘time-bound’ conditions – such as those receiving chemotherapy – may need to be removed.

Clinical decisions should continue to be taken based on the criteria set by the chief medical officer and following a conversation with the patient, said NHS England.

The bulletin, sent by NHS England’s director of primary care Dr Nikita Kanani and director of primary care strategy Ed Waller, said: ‘The chief medical officer has now confirmed that renal dialysis patients should be advised to shield.

‘Where they have not already done so, renal units will get in touch with patients, send them a letter and add them to the shielded patient list via the regular trust submissions to NHS Digital. GPs are asked to note this update, but no further action is required at this point.’

Four more conditions were recently added to the list of conditions that mean patients are considered clinically most vulnerable from coronavirus (Covid-19) infection and should shield protectively.

Patients with interstitial lung disease, bronchiectasis and pulmonary hypertension have now been identified as requiring shielding, according to the RCGP, which also noted patients who have had a splenectomy were ‘mistakenly’ missed off the original list and should also shield.