[MI] Coronavirus Shielded Patient List Summary Totals, England

This is a release of management information about patients previously identified as clinically extremely vulnerable (CEV), due to a combination of individual characteristics and pre-existing health conditions and at high risk of death from coronavirus (also referred to as COVID-19), who were on the Shielded Patient List (SPL).

The purpose behind the public release of SPL data was to make available anonymous and summarised regional and local data to allow for its use in public health analysis.

The shielding programme in England has now ended, which means that those who were previously identified as CEV are no longer being asked to shield. However, the list is currently still being held and maintained by NHS Digital as information about those who were previously identified as CEV patients and is used by health and social care services to provide care and treatment, to plan health and social care services, and to carry out medical research.

From October 2021, following the advice to end the shielding programme, updates to the SPL dashboard stopped. The final dashboard and release of management information is based on version 75 of the SPL clinical methodology, with the data extracted on 30 September 2021. The SPL dashboard and management information were last updated on 07 October 2021.

NHS Digital is conducting a managed closure of the SPL and this Transparency Notice will be updated to reflect any further changes as and when required.

The open data files and dashboard contain the following analysis:

• a count of patients by CCG of residence, broken down by demographics (age band or gender) or disease group

• a count of patients by Local Authority (LA) of residence, broken down by demographics (age band or gender) or disease group

• a count of patients by Upper Tier Local Authority (UTLA) of residence, broken down by demographics (age band or gender) or disease group

Data Caveats

This data was accurate at the time of production.

To protect patient confidentiality:

• all sub-national data was rounded to the nearest 5

• patient counts between 1 and 7 were suppressed and shown as '*'

• local authorities of Cornwall and Isles of Scilly were combined to create a larger geographical area

• local authorities of Hackney and City of London were combined to create a larger geographical area

A living patient was defined as any patient who did not have at least one of the informal or formal notification of death flags within the Personal Demographics Service (PDS) data.

Age bands used were 18 - 29 years, 30 - 39 years, 40 - 49 years, 50 - 59 years, 60 - 69 years, 70 - 79 years, 80 - 89 years, and 90 years and older. Age was calculated where a patient's date of birth (DoB) was present and was calculated from the DoB up to the date of the SPL extract.

Gender was defined as the sex at birth recorded within the PDS. Only data for male or female genders was included in this analysis.

If a patient was added or removed by both a GP and a hospital doctor, the GP assessment took priority.

If a patient was added or removed by either a GP or a hospital doctor, the latest reported request took precedence over the national methodology.

CCG data only included patients who resided within a CCG in England at the date of the SPL data extract. A patient who was a resident in a devolved UK nation or who had an invalid, or unknown, CCG were excluded from the analysis though they remained on the SPL.

LA data only included patients who resided within a local authority in England at the date of the SPL data extract. A patient who was a resident in a devolved UK nation or who had an invalid, or unknown, local authority were excluded from the analysis though they remained on the SPL.

Initially thirteen adult disease groups were signed off by the CMO in England and these were assigned to patients using the clinical methodology or when a patient was added by a GP or a hospital doctor.

Patients that were added by a GP or a hospital doctor may have been assigned to a disease group, but this was not mandatory.

As a patient could be assigned to one or more disease groups, the sum of patients across all disease groups was not equal to the total number of patients on the SPL, and therefore data should not be summed in this way.

In version 36 of the SPL, the CMO added two further disease groups in the “high risk” criteria and adult patients with these conditions were identified and added to the SPL by their GP or hospital specialist. The national methodology was also updated to include patients with these conditions.

In version 44 of the SPL, the previously identified CEV patients aged 19-69 years as categorised in the COVID-19 Population Risk Assessment (PRA) were added.

In version 46, the previously identified CEV patients aged 70+ years as categorised in the COVID-19 PRA were added.

In version 52, effective on 01 April 2021, NHS England and NHS Improvement (NHSEI) approved the merging of 38 CCGs into 9 CCGs. The 38 legacy CCG codes were legally closed after 31 March 2021.

Local Authority boundary changes, also effective on 01 April 2021, were implemented in version 52 of the SPL.

In version 59, effective on 01 June 2021, the Organisational Data Service (ODS) within NHS Digital released the latest reconfiguration to include boundary changes that occurred on 01 April 2021.

In version 68, effective on 10 August 2021, NHS Digital implemented the initial run of the patient "exit" process, removing previously identified CEV patients who were no longer registered for NHS care in England. These patients were identified as having an "exit" reason in their PDS record indicating that they had left the UK or moved residence outside of England. Patient exits were processed weekly thereafter.

In version 70, effective on 25 August 2021 following a policy change directive from DHSC and DfE, all previously identified CEV patients aged under 18 years were removed from the SPL.