+ All patients that have been identified by GPs and hospital doctors
+ All patients identified using the clinical algorithm
+ All patients identified in the COVID-19 Population Risk Assessment using QCovid® methodology
- All patients where a GP or hospital doctor tells us that a person is not clinically extremely vulnerable have been removed
- All patients who have specifically asked to be removed from the list have been removed
- All deceased patients were removed using PDS – accepting one or both of the “informal” and “formal” notification of death flags
- This data does not include those patients that have self-referred on the SPL.
If a patient is added or deducted by both a GP and hospital, it is the latest request that is reported and this takes precedence over the algorithm.
This analysis has exclusions at each level of geography meaning that the totals across CCG and Local Authority may not be the same and may not match the total number of patients shown above.
CCG data only includes those patients who are resident in an English CCG. Non-English and invalid/unknown CCGs are excluded.
Local Authority data only include those patients who are resident in English local authorities. Non-English and invalid/unknown local authorities are excluded.
Initially, there were 13 disease groups, as defined in the SPL clinical methodology, that were signed off by the Chief Medical Officer (CMO). These disease groups were assigned to patients using the clinical methodology but could also be assigned when a patient was added by a GP or hospital doctor.
As more evidence becomes available about which people are more likely to become seriously unwell as a consequence of COVID-19 infection, the UK Chief Medical Officers continuously review the conditions of "high risk" criteria.
Data cannot, and should not, be summed across disease groups. A patient can be in multiple disease groups, therefore the number of patients on the list will not equal the sum of patients within each disease group.
In order to protect patient confidentiality '*' appears in the table above for all sub-national breakdowns, where it is possible to calculate a value between 1 and 7 from the data presented. All other sub-national data has been rounded to the nearest 5. For the purposes of disclosure control some local authorities have been combined to create larger areas. These are: Cornwall and Isles of Scilly; Hackney and City of London.
In version 36 of the SPL, the UK CMO instructed that two new disease groups be included in the “high risk” criteria (Adult patient with Down’s syndrome; Adult patients with kidney impairment (Stage 5 Chronic Kidney Disease)). Adult patients with these two conditions were identified and added to the SPL by their GP or hospital specialist. The national methodology was also updated to identify patients with these conditions.
In version 44 of the SPL, clinically extremely vulnerable (CEV) patients aged 19-69 years have been included in the cohort following a COVID-19 Population Risk Assessment using QCovid® methodology. The QCovid® methodology is an algorithm used to identify clinically extremely vulnerable individuals who are at an increased risk of serious illness of COVID-19 based on known risk factors (age, sex assigned at birth, height and weight (used to calculate Body Mass Index (BMI)), ethnicity, and some medical conditions known to have increased risk relating to coronavirus). QCovid® estimates an individual's combined risk of catching coronavirus, being admitted to hospital, and dying from the disease.
In version 46 of the SPL, the additional CEV patients, aged 70+ years, identified in the COVID-19 Population Risk Assessment using QCovid® methodology, have been included.
In version 52 of the SPL, effective on 01 April 2021, NHS England and Improvement (NHSEI) have approved the merging of 38 Clinical Commissioning Groups (CCGs) to create 9 new CCGs. The CCG mergers affect East of England, South East, London, Midlands, and North East and Yorkshire regions; North West and South West regions are unaffected. The 38 legacy CCG codes will legally close after 31 March 2021. There are no Sustainability and Transformation Partnerships (STP) or CCG boundary changes as part of the April 2021 CCG mergers.
Local Authority boundary changes, also effective on 01 April 2021, have been implemented within version 52 of the SPL:
E07000150 - Corby, E07000152 - East Northamptonshire, E07000153 - Kettering, E07000156 - Wellingborough are mapped to new UTLA E06000061 - North Northamptonshire
E07000151 - Daventry, E07000154 - Northampton, E07000155 - South Northamptonshire are mapped to new UTLA E06000062 - West Northamptonshire.
In version 59 of the SPL, effective on 01 June 2021, the Organisational Data Service (ODS) within NHS Digital released the latest reconfiguration to include boundary changes that occured on 01 April 2021. The 7 lower tier LA districts of Corby, Daventry, East Northamptonshire, Kettering, Northampton, South Northamptonshire and Wellingborough (E07000150 to E07000156) have been abolished and replaced by two Unitary Authorities of North Northamptonshire (E06000061) and West Northamptonshire (E06000062). The Unitary Authorities are now both lower tier (LA) and upper tier (UTLA).
In version 68 of the SPL, effective on 10 August 2021, NHSD implemented the initial run of the patient "exit" process, removing CEV patients who are no longer registered for NHS care in England. These patients have been identified as having an "exit" reason in their Personal Demographic Service (PDS) record, indicating that they have either left the UK or moved residence to one of the home countries (Scotland, Wales or Northern Ireland). Patient exits will continue to be processed weekly.
In version 70 of the SPL, following a policy change directive from DHSC and DfE, effective on 25 August 2021, all CEV patients aged under 18 years have been removed from the SPL.