Shielding list expansion: questions patients may ask and how to answer them

A Q&A covering possible questions GPs may be asked as the new QCovid risk calculation method identifies a further 1.7m people to be added to the shielding list.

GP updates: how to answer questions from patients identified as clinically extremely vulnerable via QCovid | Man on the phone | OnMedica As a further 1.7m people are being added to the shielding list following a new risk assessment with the QCovid risk calculation method, patients may find their new identification as clinically extremely vulnerable (CEV) concerning, even with the offer of vaccination. As a result, they may turn to their GPs about this.

NHS England's letter to GP practices outlines some questions patients may ask and how to answer them:

Q. What do I say to newly added patients if they receive their letter before I can see a high risk flag against them in the GP IT system?

A. We want to make sure patients are alerted that they are at risk as soon as possible. This means that GP IT providers receive information at the same time as patients receive emails and letters go to print. It can sometimes take up to 5 working days for flags to show in GP IT systems.

If a patient has received a letter, they should follow the advice included within it unless they hear otherwise subsequently.

Q. What do I say if patients ask why they are only now being identified as clinically extremely vulnerable by the QCovid tool and advised to shield?

A. Evidence about COVID-19 and the factors that lead people to become seriously ill
is constantly improving.

These individuals have been identified by a new risk assessment model, commissioned by the Chief Medical Officer for England, to predict a person’s risk of becoming seriously unwell from COVID-19.

This model has been developed using data which was gathered during the first wave of the pandemic. It has been through the most rigorous standards of review and testing and this is the earliest time that it has been available to identify patients at a national level in this way. We are acting as rapidly as possible to implement this, in order to help inform the immediate prioritisation of COVID vaccination and make sure patients are provided with the right advice and support.

Q. Do clinically extremely vulnerable patients have to follow shielding advice if they don't want to?

A. Patients at high risk of severe outcomes from COVID-19 infection are strongly encouraged to follow shielding guidance. However, this is advice, and not the law. Patients can choose whether or not they want to follow it.

Q. Are there likely to be patients who have been added in error by the QCovid tool?

A. If certain information is missing from a patient’s record, then default values have been used as a substitute to calculate risk assessment results. A precautionary approach has been taken, to allow patients identified as at high risk to access vaccination, support and advice including to shield. Clinicians can use the COVID-19 Clinical Risk Assessment Tool to review a patient’s risk assessment results (more information is available on the NHS Digital website), and can add or remove patients from the SPL as per the usual process.

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