• Large CCG identified 37,000 patients it believed should receive food and medicine deliveries under government programme
  • This followed instructions from NHS England, but the national body has now suggested the patients are not eligible
  • MP Rosie Cooper accuses national leaders of “throwing the problem at local health organisations or local councils”

Thousands of vulnerable patients who local commissioners and GPs believe need to be “shielded” from coronavirus are being denied access to central support.

According to emails seen by HSJ, a large clinical commissioning group in the North West identified 37,000 patients it believed are the most at-risk from covid-19 and should be eligible for food and medicine deliveries under a government programme. This followed an instruction from national leaders for GPs to write to patients they felt should be on the list.

But NHS England has now suggested the patients are not eligible, and their support needs may have to be met by local bodies.

On 21 March the chief medical officer wrote to all GPs about the government’s plan to support patients at the highest risk from the virus. NHS Digital compiled a central list using hospital episode statistics, which identified around 1.3 million patients, but the CMO’s letter also asked local doctors to help by identifying and writing to additional patients who met the crieria but were not picked up in the national data.

Liverpool CCG appears to have responded more quickly than others to these initial instructions, and identified 37,000 patients it believed met the criteria for support [on top of 11,000 identified nationally]. According to emails seen by HSJ, the CCG’s list was checked by its practices and letters were sent out to the patients within a week.

However, in an email to local MP Rosie Cooper and the regional NHS England team, the CCG’s chief officer Jan Ledward said the national guidance was “subsequently withdrawn and reissued”. The new guidance told GPs to disregard “other sources of guidance asking you to identify and contact large numbers of extra patients”, which appears to include the list compiled by the CCG.

But by this time, tens of thousands of patients in Liverpool had received their letters, and had tried unsuccessfully to access the government website to claim support.

In a reply to Ms Ledward and Ms Cooper, NHS England regional director of commissioning in the North West, Dr Linda Charles-Ozuzu, said the Liverpool CCG letter was sent to a “wider cohort” of patients [than that identified by the national guidance].

She added: “We are following up with national colleagues to see what central support can be provided to this wider group. We need to look at how all these patients are supported – this may include looking at local support offers to bridge the gap.”

Rosie Cooper, MP for nearby West Lancashire, told HSJ a friend of hers had received the CCG letter but has been unable to access support.

She said: “That so many vulnerable people have been misled by the government into thinking that they would receive help whilst being shielded is simply a disgrace.

“It is no good throwing the problem at local health organisations or local councils without providing the money or resources to enable them to deliver.

“People will die if they are forced to leave their homes for food or medicine because the government failed and didn’t keep their promise to protect them.”

It is nearly three weeks since the CMO announced the shielding list would be brought into effect and it has caused frustration among GPs who have been fielding calls from confused and worried patients that have been told they are on the list of most at risk patients erroneously, or have not been told and believe they should be.

An NHS England bulletin to GPs on 8 April said the process was complete and letters were on their way to the most vulnerable patients. It said the centre had added flags on patient records and letters had gone to GPs so they could double check the updated list, adding or removing patients as they see fit.

Patients qualifiying for the shielded list include those with specific cancers, solid organ recipients, and those on immunosuppression therapies. The full list of criteria were set out in the 21 March letter.

NHS England’s regional team was approached for comment.

Liverpool CCG said in a statement: “We have communicated with everyone on the list to reassure them we are working to fix this issue and asked them to get in contact if they need urgent help. We have been supported by NHSE to resolve this issue. Patients who need it, will be in a position to receive help within the next 7 days or so.”