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
6 Recommendations
20 Conclusions
1 Report
1 Oral session
2 Letters
1 Event
Activity timeline 5 events
2 Nov
2021
Correspondence
2 Sep
2021
Report published
21 Apr
2021
Report published
16 Mar
2021
Correspondence
22 Feb
2021
Oral evidence
Oral evidence sessions 1 session
22 Feb 2021
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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
14 results
Clear
2 Recommendation Accepted
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
Government Response
The government commits to learning lessons from identifying CEV people and improving national data use. Work is underway on a national GP dataset and digitising the health service with shared care records, which will be detailed in a forthcoming draft data strategy for health and social care.
HM Treasury
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3 Recommendation Accepted
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
The government agrees there was huge local variation and commits to conducting further analysis to understand the drivers and identify lessons for the future, with findings to be provided to the Committee by October 2021.
HM Treasury
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4 Recommendation Accepted
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
The government disagreed that a centrally-directed system was chosen due to lack of confidence in local authorities, highlighting councils as crucial partners. They stated that councils received funding, demonstrated good performance, and MHCLG continues to work closely with them and keep funding under review to ensure their capacity and resilience.
HM Treasury
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8 Conclusion Accepted
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
The government acknowledges the difficulties faced by non-clinically vulnerable groups and highlights existing support services such as priority supermarket referrals and NHS Volunteer Responders, committing to consider future preparedness measures for such groups.
HM Treasury
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9 Conclusion Accepted
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
The government disagrees with the conclusion that identification took too long but states it is committed to learning lessons and that work is already underway to develop a strategic national GP dataset, digitize the health service, and publish a data strategy.
HM Treasury
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12 Conclusion Accepted
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
The government stated that work is already underway, with NHS Digital developing a national GP dataset for faster access to information and working on digitising health records and shared care. These developments will be outlined in a forthcoming data strategy for health and social care.
HM Treasury
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13 Conclusion Accepted
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
The government agrees to provide a detailed explanation for the local variation in the shielded patient list growth and identify lessons for a consistent clinical approach, committing to send these findings to the Committee by October 2021.
HM Treasury
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14 Conclusion Accepted
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
The government agrees to provide a detailed explanation for the local variation in the shielded patient list growth and identify lessons for a consistent clinical approach, committing to send these findings to the Committee by October 2021.
HM Treasury
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15 Conclusion Accepted
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
The government agrees to provide a detailed explanation for the local variation in the shielded patient list growth and identify lessons for a consistent clinical approach, committing to send these findings to the Committee by October 2021.
HM Treasury
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16 Conclusion Accepted
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
The government disagreed that there was huge local variation, stating that most areas fell within expected distributions, while acknowledging six areas added more people than expected. They committed to conducting further analysis to understand this variation and identify lessons, with findings to be reported to the Committee by October 2021.
HM Treasury
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17 Recommendation Accepted
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
The government accepts the recommendation and states it has tested future delivery confidence with councils, finding them confident to rapidly stand up shielding support, and continues to work closely with them while keeping funding under review.
HM Treasury
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20 Conclusion Accepted
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
Government Response
The government states it agrees with the recommendation (likely an implicit one regarding local authority capacity) and considers it implemented. MHCLG has tested future delivery confidence with councils and continues to work closely with them to ensure support for CEV individuals.
HM Treasury
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24 Conclusion Accepted
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
The government acknowledges the issue of inaccurate contact details and states NHSX is leading a program to improve patient contact details and ensure the NHS Number is the primary identifier. DHSC and NHS Digital will report back with details of ongoing work and plans.
HM Treasury
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26 Conclusion Accepted
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
The government stated that during the shielding program, DHSC used letters to encourage CEV people to update their GP contact details to facilitate communication, aligning with the committee's observation.
HM Treasury
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Government Response AI assessment · 26 of 6 classified
Accepted 14
Acknowledged 5
Not Addressed 2
Rejected 5
Total 6 recs + 20 conclusions
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