Covid-19: Supporting the vulnerable during lockdown

Public Accounts Committee Closed Inquiry
Opened: 1 Feb 2021 Closed: 28 Jun 2021 Parliament page
Starting from the end of March 2020, the government advised some 2.2 million people who it considered to be “clinically extremely vulnerable” to covid-19 that they should shield at home for 12 weeks, to protect themselves from the virus. For those shielding, the government offered support with food and medicine, … Read more
1 Recommendation
25 Conclusions
1 Report
1 Oral session
2 Letters
1 Event
Activity timeline 6 events
2 Nov
2021
Correspondence
2 Sep
2021
Report published
21 Apr
2021
Report published
16 Mar
2021
Correspondence
22 Feb
2021
Oral evidence
22 Feb
2021
Formal meeting (oral evidence session) · The Wilson Room, Portcullis House
Oral evidence sessions 1 session
22 Feb 2021
View on parliament.uk
COVID-19: Supporting the vulnerable during lockdown
Ben Llewelyn · MHCLG David Kennedy · Department for Environment, Food and Rural Affairs Dr Jenny Harries OBE · UK Health Security Agency Jeremy Pocklington CB · Ministry of Defence Lee McDonough · Department for Energy Security and Net Zero Mark Reynolds · NHS Digital Sir Chris Wormald · Department of Health and Social Care
Title HC No. Published Items Response
Fifty-Third Report - Covid 19: supporting the vulnerable during … HC 938 21 Apr 2021 26 Responded
Recommendations & Conclusions
26 results
2 Recommendation
Fifty-Third Report - Covid 19: sup…
DHSC and NHS Digital took too long to identify all clinically extremely vulnerable people.
DHSC and NHS Digital took too long to identify all clinically extremely vulnerable people. Individuals were not formally eligible for the central support of food boxes and medicines delivery offered through the shielding programme until they were on the Shielded … Read more
HM Treasury
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3 Conclusion
Fifty-Third Report - Covid 19: sup…
Huge local variation strongly suggests that GPs were inconsistent when judging who was clinically extremely...
Huge local variation strongly suggests that GPs were inconsistent when judging who was clinically extremely vulnerable and should therefore be advised to shield and be eligible for support. As well as NHS Digital using national data to identify clinically vulnerable … Read more
Government Response
agree with the conclusion that there was huge local variation. NHS Digital and DHSC have already written to the Committee with an initial analysis of the local variation in growth … Read more
HM Treasury
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4 Conclusion
Fifty-Third Report - Covid 19: sup…
Government chose a centrally-directed system to support clinically vulnerable people as it did not have...
Government chose a centrally-directed system to support clinically vulnerable people as it did not have confidence all local authorities and supermarkets could meet people’s needs, particularly for food. MHCLG spoke with some local authorities and supermarkets early on to assess … Read more
Government Response
agree with the conclusion that a centrally directed system was chosen because of a lack of confidence in local authorities. Councils are crucial partners in delivery of shielding support to … Read more
HM Treasury
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5 Conclusion
Fifty-Third Report - Covid 19: sup…
MHCLG and DHSC do not know whether 800,000 clinically extremely vulnerable people slipped through the...
MHCLG and DHSC do not know whether 800,000 clinically extremely vulnerable people slipped through the net and missed out on much needed support. DHSC explains that it took a ‘multi-channel’ approach to engaging with those affected. Through this approach, it … Read more
Government Response
5.1 The government disagrees with the Committee’s recommendation. 5.2 The government disagrees with both the Committee’s conclusion and recom- mendation. People who are clinically extremely vulnerable have been identified by … Read more
HM Treasury
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6 Conclusion
Fifty-Third Report - Covid 19: sup…
Missing or inaccurate telephone numbers in NHS patient records undermined government’s efforts to contact 375,000...
Missing or inaccurate telephone numbers in NHS patient records undermined government’s efforts to contact 375,000 people. The contact centre relied on telephone numbers in NHS patient records when calling people to check their needs. Over 20% of the 1.8 million … Read more
Government Response
2021. This is the Government’s response to the Committee’s report. Relevant reports • NAO report: management of the Industrial Strategy Challenge Fund – Session 2019-21 (HC 1130) • PAC report: … Read more
HM Treasury
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1 Conclusion
Fifty-Third Report - Covid 19: sup…
On the basis of a report by the Comptroller and Auditor General, we took evidence...
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health & Social Care (DHSC), Ministry of Housing, Communities & Local Government (MHCLG), Department for Environment, Food & Rural Affairs (Defra), … Read more
Government Response
On 22 March 2020, the Secretary of State for Housing, Communities and Local Government announced that those people in England who faced the highest risk of being hospitalised by COVID-19 … Read more
HM Treasury
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7 Conclusion
Fifty-Third Report - Covid 19: sup…
As its understanding of the disease has grown, DHSC has developed a new risk assessment...
As its understanding of the disease has grown, DHSC has developed a new risk assessment tool, QCovid, to identify people at risk based on wider factors which make them at more risk from COVID-19. DHSC described the tool as having … Read more
Government Response
1.2 Shielding is an intervention to protect the clinically extremely vulnerable to reduce risk of severe illness or death. It is, therefore necessarily linked to susceptibility to disease. Shielding support … Read more
HM Treasury
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8 Conclusion
Fifty-Third Report - Covid 19: sup…
DHSC told us it recognised that advising people to stay inside and away from society...
DHSC told us it recognised that advising people to stay inside and away from society does have risks as well as benefits. Of those surveyed, some 36% reported worsening mental health and wellbeing while shielding.14 Charities also told us of … Read more
Government Response
1.3 There are other non-clinically vulnerable groups who also faced difficulties during the pandemic. It was not appropriate to advise these groups to shield, and consequently were not eligible for … Read more
HM Treasury
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9 Conclusion
Fifty-Third Report - Covid 19: sup…
The list of medical conditions that the chief medical officers developed to define clinically extremely...
The list of medical conditions that the chief medical officers developed to define clinically extremely vulnerable people was shared with NHS Digital on 18 March 2020. DHSC tasked NHS Digital to use patient data to identify those affected and create … Read more
Government Response
2.2 Whilst the government agrees with the Committee’s recommendation, it does not agree with the conclusion that DHSC and NHS Digital took too long to identify all clinically extremely vulnerable … Read more
HM Treasury
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10 Conclusion
Fifty-Third Report - Covid 19: sup…
NHS Digital created the first iteration of the list of some 900,000 people within two...
NHS Digital created the first iteration of the list of some 900,000 people within two days using readily accessible data sources—hospital, maternity and prescribed medicines data. By 12 April 2020, three weeks after shielding began, a further 420,000 people had … Read more
Government Response
2.2 Whilst the government agrees with the Committee’s recommendation, it does not agree with the conclusion that DHSC and NHS Digital took too long to identify all clinically extremely vulnerable … Read more
HM Treasury
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11 Conclusion
Fifty-Third Report - Covid 19: sup…
As well as NHS Digital using patient data to add people to the shielding list,...
As well as NHS Digital using patient data to add people to the shielding list, GPs and hospital doctors were asked to review the list and use their clinical judgement to add or remove people. GP and hospital doctors’ additions … Read more
Government Response
2.2 Whilst the government agrees with the Committee’s recommendation, it does not agree with the conclusion that DHSC and NHS Digital took too long to identify all clinically extremely vulnerable … Read more
HM Treasury
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12 Conclusion
Fifty-Third Report - Covid 19: sup…
DHSC acknowledged that there are advantages with NHS data systems—such as having large amounts of...
DHSC acknowledged that there are advantages with NHS data systems—such as having large amounts of data—and disadvantages, for example challenges in connecting and using legacy systems.24 We asked NHS Digital what would help to identify patients earlier. NHS Digital told … Read more
Government Response
2.3 Work is already underway on this. NHS Digital has developed a strategic national GP dataset alongside the profession. This will allow faster access to GP information that will be … Read more
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13 Conclusion
Fifty-Third Report - Covid 19: sup…
NHSE&I asked GPs and hospital doctors to add or remove people from the list, based...
NHSE&I asked GPs and hospital doctors to add or remove people from the list, based on their clinical judgement, and as their patients’ conditions or treatments changed over time.26 However, the extent to which the list grew between 12 April … Read more
Government Response
3: PAC conclusion: Huge local variation strongly suggests that GPs were inconsistent when judging who was clinically extremely vulnerable and should therefore be advised to shield and be eligible for … Read more
HM Treasury
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14 Conclusion
Fifty-Third Report - Covid 19: sup…
NHSE&I was not responsible for managing any local variations and did not challenge local clinical...
NHSE&I was not responsible for managing any local variations and did not challenge local clinical decisions.28 DHSC has told us that NHSE&I and NHS Digital considered that ultimately additions were a decision for local clinicians. It noted that the approach … Read more
Government Response
3: PAC conclusion: Huge local variation strongly suggests that GPs were inconsistent when judging who was clinically extremely vulnerable and should therefore be advised to shield and be eligible for … Read more
HM Treasury
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15 Conclusion
Fifty-Third Report - Covid 19: sup…
NHS Digital told us that for the people whom it had identified and added centrally...
NHS Digital told us that for the people whom it had identified and added centrally to the list, in line with the clinical criteria set by the chief medical officers, there is very little variation by area.30 DHSC acknowledged that … Read more
Government Response
3: PAC conclusion: Huge local variation strongly suggests that GPs were inconsistent when judging who was clinically extremely vulnerable and should therefore be advised to shield and be eligible for … Read more
HM Treasury
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16 Conclusion
Fifty-Third Report - Covid 19: sup…
We asked DHSC if it had created a postcode lottery of support, and if people...
We asked DHSC if it had created a postcode lottery of support, and if people with certain conditions in some areas, would have different support to people in other areas with the same conditions.32 DHSC told us that it did … Read more
Government Response
3.2 Whilst the government agrees with the Committee’s recommendation, it does not agree with the conclusion that there was huge local variation. NHS Digital and DHSC have already written to … Read more
HM Treasury
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17 Conclusion
Fifty-Third Report - Covid 19: sup…
Government quickly needed to ensure that those shielding had reliable access to food, medicines and...
Government quickly needed to ensure that those shielding had reliable access to food, medicines and care. It chose a national system of support run by central government.36 MHCLG considered that a centralised offer was more likely to guarantee delivery of … Read more
Government Response
4: PAC conclusion: Government chose a centrally-directed system to support clinically vulnerable people as it did not have confidence all local authorities and supermarkets could meet people’s needs, particularly for … Read more
HM Treasury
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18 Conclusion
Fifty-Third Report - Covid 19: sup…
Defra was chosen to lead on providing food to people shielding because, according to MHCLG,...
Defra was chosen to lead on providing food to people shielding because, according to MHCLG, it had the expertise and relationships with the food industry.42 Defra consulted with supermarkets and wholesalers, to understand their capacity to provide people with food, … Read more
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19 Conclusion
Fifty-Third Report - Covid 19: sup…
In August 2020, the government conducted an early lessons learned review of the programme which...
In August 2020, the government conducted an early lessons learned review of the programme which noted that, should shielding be needed again, a local support model could improve flexibility and potentially be more cost-effective.46 MHCLG told us how it started … Read more
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20 Conclusion
Fifty-Third Report - Covid 19: sup…
This locally-led model focused on providing eligible people with priority access to book supermarket deliveries,...
This locally-led model focused on providing eligible people with priority access to book supermarket deliveries, rather than Government providing standard food parcels.48 Defra told us that almost everybody that signed up for food box support was matched and prioritised by … Read more
HM Treasury
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21 Conclusion
Fifty-Third Report - Covid 19: sup…
Government used a range of ways to engage with clinically vulnerable people, to advise them...
Government used a range of ways to engage with clinically vulnerable people, to advise them to shield and how to register to access support.51 Government wanted all affected to register whether they needed support or not. NHSE&I and DHSC were … Read more
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22 Conclusion
Fifty-Third Report - Covid 19: sup…
DHSC and MHCLG explained that for the 800,000 vulnerable people that the contact centre could...
DHSC and MHCLG explained that for the 800,000 vulnerable people that the contact centre could not reach, their contact details were passed to local authorities, as it was thought local authorities might be better placed to contact these people and … Read more
Government Response
5: PAC conclusion: MHCLG and DHSC do not know whether 800,000 clinically extremely vulnerable people slipped through the net and missed out on much needed support. 5: PAC recommendation: MHCLG … Read more
HM Treasury
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23 Conclusion
Fifty-Third Report - Covid 19: sup…
We asked MHCLG how many extra people took up the offer of support after being...
We asked MHCLG how many extra people took up the offer of support after being contacted by local authorities. MHCLG confirmed that it did not collect this information and explained that it is difficult to disentangle how many people registered … Read more
Government Response
6: PAC conclusion: Missing or inaccurate telephone numbers in NHS patient records undermined government’s efforts to contact 375,000 people. 6: PAC recommendation: DHSC and NHS Digital should ensure that different … Read more
HM Treasury
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24 Conclusion
Fifty-Third Report - Covid 19: sup…
The DWP contact centre relied on telephone numbers in NHS patient records to call clinically...
The DWP contact centre relied on telephone numbers in NHS patient records to call clinically vulnerable people who had not yet registered their needs. In some 375,000 cases out of the 800,000 people that the contact centre could not get … Read more
Government Response
6.2 Whilst the government agrees with the Committee’s recommendation, it does not agree with the conclusion that the lack of up to date phone numbers had a material impact on … Read more
HM Treasury
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25 Conclusion
Fifty-Third Report - Covid 19: sup…
MHCLG considered that it established a communication strategy that took all reasonable steps to reach...
MHCLG considered that it established a communication strategy that took all reasonable steps to reach people.58 DHSC explained how it used a ‘multi-channel’ approach to communicate with clinically vulnerable people: its preference was to contact people using letters first as … Read more
Government Response
5.2 The government disagrees with both the Committee’s conclusion and recom- mendation. People who are clinically extremely vulnerable have been identified by the NHS through clinical records. The government has … Read more
HM Treasury
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26 Conclusion
Fifty-Third Report - Covid 19: sup…
DHSC told us it is trying to improve contact information by asking clinically extremely vulnerable...
DHSC told us it is trying to improve contact information by asking clinically extremely vulnerable people to ensure their GP records are up to date and will continue to update the records as patients improve their record keeping with their … Read more
Government Response
6.3 During the shielding programme DHSC used shielding letters to encourage CEV people to update their contact details with their GPs, as this would allow the department to send more … Read more
HM Treasury
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Correspondence 2 letters
2 Nov 2021 Correspondence from Sir Chris Wormald KCB, Permanent Secretary, Department of Health and Social Care, re 53rd Report session 2019-21 – Covid-19 Supporting the vulnerable, dated 26 October 2021
Parliament page
16 Mar 2021 Correspondence from Sir Chris Wormald, Permanent Secretary, Department of Health and Social Care, re COVID-19: Supporting the vulnerable during lockdown, dated 10 March 2021
Parliament page