SPL Inclusions
+ All patients that have been identified by GPs and hospital doctors
+ All patients identified using the clinical algorithm
SPL Exclusions
- 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.
Data Caveats
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.
There are 13 disease groups as defined in the SPL clinical algorithm that have been signed off by the Chief Medical Officer (CMO). These disease groups are assigned to patients using the clinical algorithm but can also be assigned when a patient is added by a GP or hospital doctor.
The Royal College of Paediatrics and Child Health (RCPCH) guidance has been endorsed by DHSC policy. It states a differing set of risk criteria for under 18s based upon clinical evidence from the COVID-19 pandemic.
The two children and young people's disease categories (Oncology, Immunodeficiency and immunosuppression) have been added to the SPL disease group dashboard. Patients that are under 18 who have triggered on the adult methodology have been removed from the Adult SPL disease group counts.
However, more evidence is now available than at the start of the pandemic about which people are more likely to become very unwell as a consequence of COVID-19 infection. As a result, the UK Chief Medical Officers have instructed that two new conditions be included in the “high risk” criteria:
- Adult patient with Down’s syndrome.
- Adult patient with kidney impairment (Stage 5 Chronic Kidney Disease).
Adult patients with these two new conditions are now being identified and added to the SPL by their GP or hospital specialist respectively. The national methodology will also be updated to identify people with these conditions.
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