NHS England's top GP apologises over shielded patient lists

NHS England medical director for primary care Dr Nikki Kanani has apologised to GPs over the way it has handled identifying patients who need to 'shield' during the coronavirus outbreak.

NHS England primary care medical director Dr Nikki Kanani
NHS England primary care medical director Dr Nikki Kanani

In a webinar last Thursday, Dr Kanani said the process had been 'really frustrating and I'm sorry about that'.

NHS England has also told GPs that it is extending the deadline for them to verify patients who have self identified as at-risk until Tuesday 28 April. They had originally been told they would need to complete this work by the end of Monday this week, but many practices have yet to receive their list.

At the start of the coronavirus outbreak practices were told that they would play a key role in supporting the patients most at-risk from COVID-19 and who were expected to shield themselves by remaining at home for at least 12 weeks.

However, the process for identifying these patients has been fraught with confusion. Around 900,000 patients were initially identified from hospital data and automatically sent a text or letter advising them to shield at the end of March.

At the time, GPs were also sent guidance about adding further patients to the list, which NHS England later told them to disregard – although only after many practices had already started this work. Instead, NHS England centrally identified a further 400,000 patients using primary care data, and letters started being sent to this group from 7 April.

GP practices only had access to final lists of patients asked to shield just before Easter - and were suddenly instructed to review these to ensure the correct patients had been identified by the end of Easter Monday, a deadline that was eventually extended to the end of the following day.

Tight deadlines

Dr Kanani said: '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. My apologies, for what that is worth.

'I recognise that you've been waiting to do something then all of a sudden there was a deadline. 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.'

She added: '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.'

Along with the patients who have been identified centrally, people have also been able to self-identify as being at high risk on the government website.

NHS England has said that GPs should receive this list of patients before 24 April and they have until 28 April to review this. GPs had originally been told they would receive the list by 17 April and needed to complete their checks by the end of today.

However, Dr Kanani predicted that the number of patients involved would be very small. She said that for a 10,000-patient practice she expected there to be 'about 20 patients' that would be added to the list 'at the very most'.

She said that, given the work practices have already done, many of the patients who had self-identified would already be on practices' shielded patient lists.

Support for patients

Patients who are on the shielded lists will be able to access government support for food and medicines delivery – although support will be focused initially on people who have no other means of obtaining food and medicine. To obtain this help, patients are also required to register here: https://www.gov.uk/coronavirus-extremely-vulnerable

GPs can also refer any patients that they feel need extra help, including those who are shielding, to the NHS Volunteers programme here or by calling 0808 196 3382.

Read more: How practices should support vulnerable patients during the COVID-19 outbreak

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