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Feb 16, 2021

  • New predictive risk model to help clinicians identify adults with multiple risk factors that make them more vulnerable to COVID-19
  • Over 800,000 adults will now be prioritised to receive a vaccine as part of the current vaccination cohorts.
  • Research developed by subgroup of NERVTAG, led by the University of Oxford and funded by National Institute for Health Research

New technology has been introduced in England to help clinicians identify for the first time, a new group of people who may be at high risk from COVID-19. Over 800,000 adults will now be prioritised to receive a vaccine as part of the current vaccination cohorts.

The technology analyses a combination of risk factors based on medical records, to assess whether somebody may be more vulnerable than was previously understood, helping clinicians provide vaccination more quickly to them and ensuring patients can benefit from additional advice and support.

This assessment is made possible today for the first time thanks to new technology and emerging evidence about the impact of COVID-19 on different groups and who could be most vulnerable, which means further steps can be taken to protect those most at risk.

The research, commissioned by England’s Chief Medical Officer Chris Whitty and funded by the National Institute of Health Research, found there are several health and personal factors, such as age, ethnicity and BMI, as well as certain medical conditions and treatments, which, when combined, could mean someone is at a higher risk from COVID-19.

The University of Oxford turned their research into a risk prediction model called QCovid®, which has been independently validated by the Office for National Statistics (ONS) and is thought to be the only COVID-19 risk prediction model in the world to meet the highest standards of evidence and assurance.

NHS Digital used the University of Oxford’s model to develop a population risk assessment. The risk assessment uses the model to predict on a population basis whether adults with a combination of risk factors may be at more serious risk from COVID-19, enabling them to be flagged to clinicians for priority access to vaccination, alongside appropriate advice and support. These individuals will be added to the Shielded Patient List on a precautionary basis and to enable rapid vaccination.

The research to develop and validate the model is published in the British Medical Journal along with the underlying model for transparency. Additional code underpinning the QCovid® model will be made available openly by the University of Oxford within a month. As our scientific understanding of the virus develops, we can update the model.

Up to 1.7 million patients have been identified. Those within this group who are over 70 will have already been invited for vaccination and 820,000 adults between 19 and 69 years will now be prioritised for a vaccination.

The patients identified through the risk assessment will be sent a letter from NHS England in the coming days explaining that their risk factors may help identify them as high clinical risk and that they are included within the support and advice for the clinically extremely vulnerable. They will be invited to receive a COVID-19 vaccine as soon as possible if they haven’t already had the jab, and will be given advice on precautionary measures, including shielding where this is current advice. Their GPs are also being notified.

  • During this national lockdown, we are advising all clinically extremely vulnerable people to  follow shielding guidance.
  • As soon as an individual is flagged as potentially clinically extremely vulnerable by NHS Digital’s COVID-19 population risk assessment, they will be sent a letter outlining how they have been identified, that they are being added to the Shielded Patient List as a precautionary measure, and highlighting additional guidance to support them.
  • For most, they will be have been identified as high risk because they have a combination of underlying health conditions or undergoing specialist treatment and they may be able to discuss this when they get their vaccination.
  • As a result of their addition to the high risk group, patients will receive a letter inviting them for vaccination as soon as possible.
  • Patients can speak to their GP or specialist clinician if they have questions as to why they have been added to the Shielded Patient List, or if they feel they should no longer be identified as clinically extremely vulnerable. GPs and specialist clinicians will be able to make their own assessment of an individual based on their clinical knowledge and are able to add and remove individuals from the shielded patient list.

It is important therefore to check that your GP and specialist team are communicating with each other about your health.

  • For now, there will be no changes to the existing list of medical conditions used to identify individuals who may be clinically extremely vulnerable to COVID-19. This list is agreed by the four UK Chief Medical Officers on the basis of the latest available evidence.
  • The previous shielding guidance extended until 21 February. It will now be extended until 31st March.