COVID-19 Episode 6: Shielding

There have been a lot of questions within primary care regarding shielding and vulnerable patients. Sara and Lisa speak to Dr Joanna Bircher and Dr Viren Mehta about the confusion and get their thoughts on the subject.

In the episode we cover:

• Demystifying all of the terminology and putting it into simpler terms.
• What has been asked of primary care with regards to these lists of patients, tips on how to complete these tasks and where to look for help.
• How to support extremely vulnerable/shielded and vulnerable patients as a practice, and how to safely manage clinical issues that arise for these people during COVID-19.
• Other groups of patients that might need extra support but don’t fall into the shielded (extremely vulnerable, high risk) category.
• Patient employment issues in primary care with relation to shielding.

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Useful resources: 

• Guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19 (17th April 2020): https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19
• NHS Guidance and updates for GPs - Highest clinical risk patients: https://www.england.nhs.uk/coronavirus/publication/guidance-and-updates-for-gps-at-risk-patients/
  
• RCGP - Shielding vulnerable patients from Covid-19 (April 2020): https://elearning.rcgp.org.uk/course/view.php?id=377
  
• NHS Digital - Coronavirus (COVID-19): Shielded patients list: https://digital.nhs.uk/coronavirus/shielded-patient-list
  
• NHS Standard operating procedures: https://www.england.nhs.uk/coronavirus/primary-care/general-practice/standard-operating-procedures/
  
• COVID-19: guidance for employees, employers and businesses: https://www.gov.uk/government/publications/guidance-to-employers-and-businesses-about-covid-19
  
• Identifying and helping to protect patients most at risk from COVID-19: https://www.rcplondon.ac.uk/news/identifying-and-helping-protect-patients-most-risk-covid-19
  
• BMA - Identifying patients at highest risk from COVID-19: advice for GPs (16th April 2020): https://www.bma.org.uk/news-and-opinion/identifying-patients-at-highest-risk-from-covid-19-advice-for-gps
• Lymphoma Action - Guidance on shielding for people who have lymphoma: https://lymphoma-action.org.uk/about-lymphoma-covid-19-and-lymphoma/guidance-shielding-people-who-have-lymphoma
• Myeloma UK - COVID-19: What measures should I be following?: https://www.myeloma.org.uk/news-and-stories/covid-19-information-hub/covid-19-what-measures-should-i-be-following/ 
• Blood Cancer UK - Coronavirus and blood cancer: https://bloodcancer.org.uk/support-for-you/coronavirus-covid-19/coronavirus-blood-cancer/
• MPN Voice - COVID-19 Outbreak: Advice for Patients with Myeloproliferative Neoplasms (MPNs) (30th March 2020): https://www.mpnvoice.org.uk/coronavirus-covid-19-advice-and-information/coronavirus_covid_19_advice_for_people_with_mpns.aspx
• CLL Support - Latest advice on COVID-19 (15th April 2020): https://www.cllsupport.org.uk/latest-advice-on-covid-19/
• Clinical guide for the management of Rheumatology patients during the coronavirus pandemic (8th April 2020): https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/clinical-guide-rheumatology-patients-v2-08-april-2020.pdf
• British Society for Gastroenterology expanded consensus advice for the management of IBD during the COVID-19 pandemic (6th April 2020): https://www.bsg.org.uk/covid-19-advice/bsg-advice-for-management-of-inflammatory-bowel-diseases-during-the-covid-19-pandemic/
• NICE - COVID-19 rapid guideline: severe asthma (3rd April 2020): https://www.nice.org.uk/guidance/ng166
• British Thoracic Society - COVID-19: identifying patients for shielding: https://www.brit-thoracic.org.uk/about-us/covid-19-identifying-patients-for-shielding/
• Good SAM Volunteer app: Patient referral form: https://www.goodsamapp.org/NHSreferral

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This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

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