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NAO says shielding is likely to have saved lives, but evidence is lacking
"Challenges pulling together data meant it took time to quickly identify those needing to shield, and therefore eligible for support. Government has learnt lessons from this programme and is better placed should this type of support be required again.” Gareth Davies, head of the NAO
The National Audit Office (NAO) has published a new report looking at how effectively the Government identified and met the needs of clinically extremely vulnerable (CEV) people up to August last year.
Among the findings were that 375,000 people in this group could not be reached due to missing or inaccurate telephone numbers.
But the NAO found that the Government acted quickly in the absence of detailed contingency plans.
At the start of the pandemic, there was no mechanism to allow a fast ‘sweep’ across all patients to identify, in real-time, those who fell within a defined clinical category.
NHS Digital used several datasets to compile the shielded patient list, including hospital data.
However, there were several issues with this – for example, hospital data was seven weeks out of date and did not always specify sufficient detail of people’s medical condition.
The report found that Government’s communications with highly clinically vulnerable people were not always clear.
Local authorities were critical of the quality of early emergency bulk food, which acted as a stop-gap while the doorstep food box deliveries were ramped up.
NHSE&I had “limited assurance” that CEV people received their medicines as and when needed.
The report notes that the Department of Health and Social Care was unable to say whether shielding led to fewer deaths and less serious illness in CEV people, although it is likely to have helped.
It adds that total expenditure on the programme up to 1 August 2020 was £308m. However given the challenges in assessing the impact of shielding on people’s health, government cannot say whether the money spent helped meet its central objective.
Gareth Davies, head of the NAO, commented: “The shielding programme was an important response to support clinically extremely vulnerable people. It provided support to many of those most at risk from COVID-19, and delivered food to just over 500,000 people.
“However, challenges pulling together data meant it took time to quickly identify those needing to shield, and therefore eligible for support. Government has learnt lessons from this programme and is better placed should this type of support be required again.”
A pdf of the report is available here