COVID-19 Population Risk Assessment
At the request of DHSC, NHS Digital has developed digital infrastructure to support a more sophisticated approach to identifying individuals with increased vulnerability to COVID-19, now that clinical determinants are better understood.
This infrastructure uses the University of Oxford’s QCovid risk prediction model, which assesses an individual’s risk based on a combination of characteristics (including age, sex, ethnicity, BMI, and specific medical conditions). DHSC commissioned Oxford University to develop the QCovid model and it has been validated by the Office for National Statistics (ONS).
We successfully used the new infrastructure for population level risk assessments for adults in England, identifying an additional 1.7 million people at increased risk of adverse outcomes from COVID-19 that were not previously included on the Shielded Patients List (SPL). This has enabled these individuals to be prioritised for vaccination as part of Cohort 6* and to be eligible for additional support through addition to the SPL from 14 February (vulnerable individuals below the age of 70) and 22 Feb (vulnerable individuals above the age of 70). These additions were then subject to review by GPs and trusts through standard SPL clinical review processes.
We delivered the COVID-19 Clinical Risk Assessment Tool for authorised users on 16 February, which is also based on the QCovid model. The tool generates absolute and relative risk scores for individuals to enable clinicians to hold tailored conversations with patients about their specific risks from COVID-19 and to facilitate clinical review of additions to the SPL COVID-19 Clinical Risk Assessment Tool NHS Digital.
Patients were added to the SPL when their risk assessment results placed them in the top 2% of people at highest risk of catching and dying of COVID-19. The threshold was agreed by England’s Chief Medical Officer, in consultation with senior clinicians, based on research conducted by the University of Oxford. To facilitate clinical review of patients whose predicted risk did not meet this threshold, NHS Digital delivered the COVID-19 Population Risk Assessment Viewer on 16 March, which enables GPs to view patients registered at their practice whose risk assessment results were below the agreed threshold.