The 2.2 million patients who have been shielding from coronavirus (Covid-19) since March have been told they are allowed outside from today, in an ‘out of the blue’ announcement that was not communicated to GPs.
The announcement was made late on Saturday night, with health secretary Matt Hancock providing more information via social media before official Government guidance was updated last night.
The intention had been for those deemed clinically extremely vulnerable to the virus to continue taking the most stringent measures against it – by not leaving their homes at all – until at least 30 June.
But the new guidance, which the Government said comes as ‘Covid-19 disease levels are substantially lower now than when shielding was first introduced’, says clinically extremely vulnerable people ‘can now leave their home if they wish, as long as they are able to maintain strict social distancing’.
The guidance said people who ‘choose to spend time outdoors’ should do so ‘with members of your own household’, or if they live alone, ‘with one person from another household’ – ‘ideally… [the] same person each time’
‘If you do go out, you should take extra care to minimise contact with others by keeping two metres apart,’ the guidance added.
With the easing to shielding guidance due today, there have been numerous concerns that clinicians, including the patients’ GPs – who had been asked to verify lists and manage patients’ clinical needs – nor general practice commissioners seemed to have been informed or consulted ahead of the announcement.
Responding to the news yesterday, NHS England’s medical director of primary care Dr Nikki Kanani said on Twitter:
🚨 I have – understandably – had a number of messages about the #shielding announcements made last night and expected today.
As soon as I know more, I will post on this thread. In the meantime, please continue to follow the guidance set out:
— Dr Nikita Kanani (@NikkiKF) May 31, 2020
Shadow health secretary Jonathan Ashworth reacted by stating: ‘The Government briefed a story overnight affecting over two million people shielding. It seems they didn’t tell NHS England’s national director of primary care nor local GPs.
‘An utterly irresponsible way to treat highly vulnerable people worried about their personal health.’
BMA GP Committee chair Dr Richard Vautrey said the guidance ‘appeared to have changed without warning’ on Saturday, and that GP practices ‘still have not received any further clarification’.
He said: ‘[T]o be able to give appropriate advice to patients, GPs need to be kept up-to-date with Government guidance and consulted on any potential changes to it; changes that directly impact the lives of those in their communities.’
Dr Vautrey said it is ‘imperative that practices are informed before public announcements, on any subject matter, so that they are in a position to support their patients as effectively as possible’.
‘Covid-19 is potentially very dangerous for those with underlying health conditions, and it is only right that we, as their family doctors, are properly prepared for any changes to guidance around their care,’ he added.
Surrey GP Dr Dave Triska told Healthcare Leader’s sister publication, Pulse: ‘I’m flabbergasted about shielding – finding out major policy changes on Twitter is obscene. No time to prepare and we’ve only just finished processing version eight of shielding!’
Blood Cancer UK described the news as a ‘bolt out of the blue’, with the statement adding: ‘In response to the news, people with blood cancer have been asking us if it’s safe for them to follow the new guidance.
‘The answer is that we don’t know, because the Government hasn’t told us the evidence behind its decision to relax it. We are urgently seeking clarity.’
The RCGP urged shielding patients to continue to remain cautious and said the Government advice was ‘not a green light’ to ‘return to our previous way of life’.
Chair Professor Martin Marshall said: ‘[W]e would advise extreme caution, particularly for those who are in the most high-risk groups, such as our patients with cancer and serious long term conditions including respiratory and heart disease.’
He added that ‘there is a very real risk that all the good work we have achieved so far in the battle against Covid-19 could be very swiftly undone, with very serious consequences’.
Lockdown in England is also being further eased for the general public from today, including allowing people from six separate households to meet outside from a social distance.
It comes as last week, health charities warned that individual patients were being removed from the shielding list, via a text message from the Government, without GPs being notified or given a chance to communicate with their patients first.
At the time, the Department of Health and Social Care said ‘the person will be informed by their clinician that they are not on the shielded patient list’.
However, in a stakeholder alert – seen by Pulse – it has admitted that in some cases patients had been sent the text first, and vowed to review the text messaging system in response.
The message said: ‘We recognise that in some cases patients have received a text before a conversation has taken place with their clinician, causing confusion.
‘We are therefore investigating the effectiveness of the process, identifying where improvements need to be made. This includes ensuring that you are all aware when we send out communications like this again.’
GPs have long been frustrated about the shielding list, which has caused various issues since it was launched in March.