Identifying and protecting vulnerable citizens

Digital infrastructure 

At the request of the Department of Health and Social Care (DHSC), NHS Digital is developing digital infrastructure to support a more sophisticated approach to identifying individuals with increased vulnerability to COVID-19. DHSC has commissioned Oxford University to develop a risk assessment tool based on a combination of specific characteristics, for example, age, sex, ethnicity, medical conditions.

On 19 November 2020 we delivered the private beta release for the clinical-facing risk stratification tool to a small cohort consisting of GPs, CCGs and primary and secondary care. Initial feedback has been positive and the private beta will continue until mid-January 2021. 

We continue to work closely with the Department of Health and Social Care to review findings from the private beta release to inform delivery of future phases and wider applications of the technology.

We are currently assessing the potential use of the Oxford Risk Calculator to support the prioritisation of clinically extremely vulnerable individuals for coronavirus (COVID-19) vaccination.

The Shielded Patient List (SPL) identifies patients at the highest risk from coronavirus (COVID-19), based on criteria set by the Chief Medical Officer for England. The shielding scheme was paused nationally on 1 August 2020 but NHS Digital continues to issue weekly iterations of the SPL to inform responses to local lockdowns. The list size remains at around 2.2m patients.

The Shielding Oversight Board approved expansion of the SPL criteria on 4 December 2020 to include patients with Down’s Syndrome and stage 5 chronic kidney disease (CKD-5).  Work is underway to add these patients to the SPL and an increase of around 50k is expected to the list size.

Around 2.4m letters and 810k emails (via the Government's Notify service) were sent to vulnerable people on the SPL to  provide guidance ahead of the move to the national tiering system on 2 December 2020. The SPL query service responded to around 3k emails from patients following the cascade, with generally positive feedback on engagement via digital channels. This provides an opportunity to expand use of email as a more dynamic, and lower cost, approach for engaging with patients.

To enable provision of free vitamin D supplements to patients on the SPL, we issued letters to patients on the SPL informing them of their eligibility for free supplements and on 29 November 2020 launched a web portal on NHS.UK to enable patients to register their interest in receiving the tablets. The new service cross-checks expressions of interested with the SPL and provides validated lists to DHSC who are responsible for fulfilment of the requests.

Get more information on vitamin D supplementation.