Imagine the Utopian scenario: it’s 5pm on Maundy Thursday. You’re about to activate your ‘out of office’ and head home to spend a relaxing weekend eating your body weight in Easter eggs.
Then your email pings. It’s a bulletin from NHS England. Easter is cancelled, and instead, you’ve got until Monday to go through your practice lists to make sure every one of your most vulnerable patients who should be ‘shielding’ is identified.
GPs had three days to finish a task NHS England had started yet failed to complete in three weeks, if all of the expected 1.5 million vulnerable people who should not leave their homes for 12 weeks were to be contacted.
NHS England had sent letters out to the patients it had identified centrally, but its IT system wasn’t up to the task of flagging up all of them.
What it did manage, however, was to attempt to contact nearly 11,000 dead people, who’d been flagged because they’d previously had radiotherapy for lung cancer.
In Wales, 13,000 letters telling people they should be shielding were sent to the wrong addresses.
GPs had to field calls and enquiries from swarms of confused and worried patients, without having all the information themselves about who should and shouldn’t be on the shielding list, prompting an apology from NHS England’s primary care director Dr Nikita Kanani for the poor handling of the whole fiasco.
A full month after lockdown started, dialysis patients were added to the growing cohort of shielders, bringing the number to 1.85 million.
Hospital clinics were responsible for contacting those newly identified renal patients – as well as people with interstitial lung disease, bronchiectasis, and pulmonary hypertension, who were also late additions to the list – but GPs needed to be on top of things too.
Patients were added, others were removed. What about diabetics? And vulnerable cancer patients?
While everyone on the ground was still trying to work out who was and wasn’t ‘extremely clinically vulnerable’, the Government announced out of the blue that shielders, who by then numbered 2.2 million, could start to venture outdoors again… well before the 12 weeks were up.
The news came as a shock for GPs, who’d only just been told that all shielding patients should have a nominated clinical lead at their practice.
When questioned by Pulse editor, Jaimie Kaffash, on the daily Covid briefing, Hancock defended the decision to suddenly and without warning ease the stringent restrictions those millions of people had been following since March, in fear of succumbing to the virus.
What followed was the inevitable barrage of questions from worried patients. On average, GPs were contacted by 12 patients each in the week after the unexpected U-turn.
The whole debacle was enough to make anyone want to stay at home. Everyone, that is, except Dominic Cummings.