Please note that the reports below are only available on the main Ardens organisation group on SystmOne and are not on the Ardens open access group due to the number of reports involved. If you do not normally use Ardens but wish to still access the reports for free you can do this just by signing up for our free trial for the course of the COVID-19 pandemic.
What is the risk classification criteria?
- High-risk patients - This specific group of patients is defined in the CMO letter and are also called ‘very high risk’, ‘vulnerable’ or ‘shielded’ patients
- Moderate-risk patients – This includes other 'At-risk' patients who are normally included in your flu reports
- Low-risk patients – This includes all other patients
What has been done already?
Patients in the ‘High Risk’ group have already been identified by central data and have been coded as high risk automatically on your behalf by NHSE/TPP with the code ‘High-risk category for developing complication from coronavirus disease 19 caused by severe'. These patients have already been sent a shielding letter centrally.
What work do I need to do?
1. Review centrally coded high-risk patients
This is to ensure that patients have been coded correctly as high risk. If there have been any patients incorrectly added to this group (false positives) you can re-record these patients as moderate or low risk to remove them from this high-risk group. Practices should have approximately 200 patients to review per 10,000 patients.
To review these patients, go to Clinical Reporting > Ardens > Alerts > COVID-19 > Alerts | Review as high risk COVD-19 recorded centrally + needs confirmation
You will then need to review these patients and then open the COVID-19 template and on the ‘Risk’ page either record the patient as:
- High risk – If they have been correctly identified as high risk (even though this has already been coded by NHSE)
- Moderate risk – If they have been incorrectly identified but are still ‘At risk’
- Low risk – If the patient is neither high or moderate risk
N.B. Practices are asked to NOT use the mark in error to remove incorrect High-risk codes, but to use the
Moderate and Low risk codes as above.
2. Review self-declared high-risk patients
Patients have been able to self-declare themselves as being at high-risk and register on the government's shielding service. A letter is being sent from NHS England to GP Practices to request that practices risk assess these patients and if appropriate then to record them as being at high risk. If you do not feel that they should be registered as high risk, you can record them as low or moderate risk instead. This can all be done via the 'Risk' page of the COVID-19 template where you will also find a pre-set letter to send these patients to inform them of this.
To review these patients, go to Clinical Reporting > Ardens > Alerts > COVID-19 > Alerts | Review as self-declared as high risk COVID-19 group but not recorded as high/mod/low risk
3. Review At-risk Group
The ‘At risk’ patients will include approximately your normal flu cohort of patients. Please note that these patients are not high risk, but would be considered unofficially as moderate risk. You may if you wish to add a ‘Moderate risk’ code to their record.
There may however be patients in this ‘At risk’ group that you deem to be at ‘High risk’, so these patients can be reviewed and recorded as ‘high risk’ on an individual basis. The ‘At risk’ group will identify approximately 3,000 patients per 10,000 patients, so this is a large number of patients. You may find it best to split these patients between their usual/registered GP and they should then be able to run their eye down the list and pick out a handful of patients that need coding as ‘High-risk’ using the COVID-19 template. N.B. Practices are advised NOT to bulk add high-risk codes using clinical searches but to review patients on an individual basis.
To review these patients, go to Clinical Reporting > Ardens > Alerts > COVID-19 > Alerts | Review as in at risk COVID-19 group but not recorded as high/mod/low risk (review individually, do NOT bulk code)
4. Sending ‘Shielding’ letters to High-Risk Patients
Once you have confirmed and identified your high-risk group of patients, you will then need to send these patients the shielding letter. This letter only needs to be sent to patients who have not already been sent the shielding letter centrally.
To identify these patients, please go to Clinical Reporting > Ardens > Alerts > COVID-19 > Alerts | High risk COVID-19 + no self-isolation/shielding letter
5. Alerts for High-Risk Patients
Many practices have social prescribers and other team members who are contacting high-risk patients to ensure they have the support that they require and that any future care planning activities are performed as appropriate. These activities can be recorded on the ‘Social Assessment’ and 'Future Care Planning' pages of the COVID-19 template.
There are also a number of reports to identify any high-risk patients who have not had a social assessment recorded yet.
To identify these patients, please go to Clinical Reporting > Ardens > Alerts > COVID-19 > Alerts | High risk ........
6. Reviewing High-Risk Patients
Following the guidance on 298/04/20, Practices have been asked to review their high-risk patients. A specific code for this does not currently exist that we’re aware of to record this activity. The ‘Educated about severe acute respiratory syndrome coronavirus 2 infection (situation)’ code has therefore been chosen and has been added to the ‘Risk’ page of the Coronavirus template. This tick box can be easily identified with a red exclamation mark and is worded ‘Educated about COVID-19 and reminder given about care.’ We’re not aware of an approved national letter to send these patients yet, but if one is provided then it will be added in due course.
There is also a report to help identify high risk patients who have not had any education since 29/04/20 (the date of the Primary Care Bulletin). To find this report, go to Clinical Reporting > Alerts > COVID-19 > Alerts | Provide education + reminder about care as high risk + no education after 29/4/20