'At Risk' Patients List - England

NHS England are providing weekly updates to the 'At Risk' patient list:

We are adding the following Medical History entry to any Applied or Permanent patients that newly qualify for the 'At Risk' list:

Important – We have been directed by NHS England to include the provided reason in Comments for these entries. This can contain sensitive information. For this reason the new entry is being added as a Priority 3 to give you time to review the entry without it automatically being loaded to the SCR when accessed.

By default the History entry has:

  • Event Date – Date the patient was added to the Shielded Patient List (SPL) as provided by NHS England
  • Read Term for Characteristic - 14Or.00 High risk category for developing complication from COVID-19 infection
  • Comment – As per the reason provided by NHS England
  • Priority – 3
  • End Date – Matches Event Date
  • Consultation Type - Administration

These patients have already been added to the national SPL and been contacted by NHS England.

These are patients that for various reasons are no longer considered ‘high risk’ and now need updating to either ‘moderate’ or ‘low’ risk.

Note – This affects any of your patients, on the Shielded Patient List (SPL), who do not have a moderate or low risk record added later than the date of the subtraction entry on the SPL Subtractions list.

This process consists of two aspects:

  1. We are adding the following Medical History entry to any Applied or Permanent patients included in this list:
    • Event Date – The date the patient was subtracted from the SPL
    • Read Term for Characteristic – Either:
      • 14Oq.00 Moderate risk category for developing complication from COVID-19 infection
      • 14Op.00 Low risk category for developing complication from COVID-19 infection
    • Comment – As per the description provided by NHS England
    • Priority – 3
    • Consultation Type – Administration
  2. The original SPL entry, of 14Or.00 High risk category for developing complication from COVID-19 infection, is updated with an End Date:
    • End Date – The date the patient was subtracted from the SPL
Note - The existing Clinical Audit continues to count the entry with the latest Event Date only, so if you have reviewed and updated a patient’s record with a ‘high’, ‘moderate’ or ‘low’ risk entry, these are the records picked up providing the Event Date is after the date received from NHS England.

NHS England have provided a copy of the letter they are sending patients when they are removed from the SPL, click here here for a Vision template of this letter for your use if required.

See What's New? for previous updates regarding your 'At Risk' patients.

Manually Recording a Patient is At Highest Risk.

If you have any patients in this vulnerable category that have not been identified with the term 9d44.00 for any reason, for example, newly registered patients, patients with new at risk diagnoses or patients prescribed drugs by a hospital, Read term 9d44.00 Potential infectious contact must be manually added to their clinical record with a Priority of 1 and "High risk category for developing complications from Covid-19" entered into free text comments.

Note - When the term 9d44.00 is added automatically to the patient record, the SNOMED description "Risk of exposure to communicable disease (situation) " is used. When the Read term 944d is added manually, the Read description "Potential infectious contact" is recorded.

Reviewing At Highest Risk Patients

You can view the patients who have had the 9d44.00 clinical term added to their record by downloading and importing the latest Coronavirus Clinical Audit from here and reviewing the Patients flagged by NHS Digital as increased risk for developing complications from Covid-19 infection (9d44) group:

The group has an active Reminder of ‘At significant increased risk from COVID-19’.

Self-Declared Patients

NHS Digital provided a one off list of patients who self-declared as ‘at risk’ on the Public Health England web site.

As instructed, we added the following record to these patients:

  • In Practice – Tick removed
  • Read Term for Characteristic - 9N38.00 Message from patient
  • Comment – ‘Added by Cegedim Health Systems on behalf of NHS Digital to flag patients self-declaring as in the high risk category for developing complications from Covid-19 infection’
  • Priority – 3
  • Consultation Type - Administration

NHS Digital have issued guidance on the processing of these patients for your reference here.

This guidance includes the templates of the two letters they are asking you to send to the two groups of patients:

Viewing your 'At Risk’ Patients

You can view the patients who have had the 9d44.00 clinical term added to their record by downloading and importing the latest Coronavirus Clinical Audit from here and reviewing the Patients flagged as increased risk for developing complications from Covid-19 infection (9d44) group:

The group has an active Reminder of ‘At significant increased risk from COVID-19’.

See Downloading and Importing Clinical Audits for details on downloading and importing Clinical Audits.
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