Shielded groups

As you will know, earlier in the year, government contacted members of the public known to be in vulnerable groups, asking them to shield themselves for 12 weeks. As a Trust, we were asked to review those on the government’s list that are known to be patients at Addenbrooke’s to ensure it is comprehensive. A central team led by consultants Amanda Cox and Anna Maw, was created to manage the Trust’s response.

Guidance for management of shielded patients during the COVID-19 pandemic is available here.

There has been an important update to the shielding programme (24.09.20)

Identifying patients at highest risk of hospitalisation if infected with coronavirus is ongoing.

With the exception of some specific areas of the UK, patients previously identified as being at highest risk form COVID-19 infection are no longer being asked to shield. However, we continue to register patients who fulfil the criteria for shielding to:

1. Ensure we are ready to advise our patients quickly if shielding for our area/nationally is re-instated

2. Ensure such patients are identifiable on EPIC to ensure they are managed appropriately when in the Trust

While this process will continue to be supported centrally, the identification of these patients now needs to be embedded in day-to-day practice within specialties as patients are newly identified. To reflect this we have now changed to the process for the registration of newly identified patients so this can be addressed as they attend clinic for diagnosis/review.

If you identify a patient to be Added to the Shielding Patient List

All three steps below MUST be completed:

• Place a flag in Epic (click ‘alerts’ on the patient banner – type SHIELDING as new alert (it will autofill))

• Generates a letter including the NHSE standard text explaining shielding using our SHIELDING SmartText.

• The SmartText is now live in Epic and is called ‘COVID-19 SHIELDING’. We will ensure the most up to date version of the NHSE letter is contained within the SmartText.
– It is suggested that a departmental blank letter template and the SmartText can be applied to the letter as per the directions at the top of page 5 in the guide for creating and sending letters by typing COVID-19 SHIELDING into the “Insert SmartText” box.”

– Send an email to shielding@addenbrookes.nhs.uk with at least three identifiable pieces of data (ideally the patient’s name, MRN, DoB, NHS number and postcode).

Patients Requesting Removal from the Shielding Patient List

• Any patient who makes contact to say they should not be on the Shielding Patient List should be directed to their Clinician, and their GP
• The Clinician can remove the SHIELDING alert flag in EPIC
• Removal from the central register must be done with involvement of, and by, the GP who will have oversight of all the patient’s medical problems

Patient Enquires

• Patient enquiries about shielding will be directed to the Clinician responsible for the patient

Highest risk patients and ED attendances

Most of the COVID-19 cases diagnosed at CUH were initially assessed and managed in our non COVID-19 ED area as COVID had not been identified on arrival of the patient as the primary diagnostic concern. Our ED has limited side rooms and cannot always ‘shield’ patients who present there who are at highest risk from other attendees. Therefore we ask all teams to consider alternative pathways for their highest risk patients, should they become unwell, to reduce the risk of hospital transmission in our busy emergency department.