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National Audit Office report: Protecting and supporting the clinically extremely vulnerable during lockdown

Protecting and supporting the clinically extremely vulnerable during lockdown

This report looks at how effectively government met the needs of clinically extremely vulnerable through the shielding programme.

Background to the report

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 should shield themselves and stay at home. This marked the start of shielding. Government guidance urged people considered clinically extremely vulnerable (CEV) to the virus to not leave their homes for 12 weeks and not go out for shopping, travel or leisure.

The objective of the shielding programme (the Programme) was to minimise mortality and severe illness among those who are CEV by providing them with public health guidance and support to stay at home and avoid all non-essential contact. Through the shielding programme, CEV people could get support accessing food, medicine and basic care.

The Ministry of Housing, Communities & Local Government had overall responsibility for overseeing and delivering the Programme. The Department of Health & Social Care was responsible for determining who should shield, evaluating the health impact of shielding and determining and issuing clinical advice. NHS Digital was responsible for producing the list of people who were to be advised to shield and working with GP systems’ suppliers on any required changes. The Department for Environment, Food & Rural Affairs led on providing food to people shielding. NHS England & NHS Improvement ran the service to get medicines to people using local pharmacies and enhanced support to CEV people through the NHS Volunteer Responder service. The Department for Work & Pensions provided a national shielding contact centre.

 

Scope of the report

This report looks at how effectively government identified and met the needs of clinically extremely vulnerable people to 1 August 2020. It only examines the support provided through the shielding programme and does not include wider support to CEV people, such as statutory sick pay. The report sets out:

• the inception of the shielding programme (Part One);
• identifying clinically extremely vulnerable people (Part Two);
• supporting clinically extremely vulnerable people (Part Three); and
• outcomes and lessons learned (Part Four).

 

Report conclusions

The shielding programme was a swift government-wide response to protect clinically extremely vulnerable people against COVID-19, pulled together at pace in the absence of detailed contingency plans. Government recognised the need to provide food, medicines and basic care to those CEV people shielding to help meet its objective of reducing the number of people suffering from severe illness and dying from COVID-19. There was impressive initial support offered to many people, with food provided to just over 500,000 people. Although the need to support was urgent, it took time for people to be identified as CEV, and therefore access formal support. This followed challenges extracting data from different IT systems and the understandable need for GPs and trusts to review the List of vulnerable people from their clinical perspective.

The Department for Health and Social Care is confident that shielding has helped to protect CEV people and it is clear that many CEV people benefited from the support the Programme provided. However, given the challenges in assessing the impact of shielding on CEV people’s health, government cannot say whether the £300 million spent on this programme has helped meet its central objective to reduce the level of serious illness and deaths from COVID-19 across CEV people. Departments have learned lessons from the first iteration of shielding from March to August 2020 and applied many of these to shielding during the second lockdown in November 2020.

 

Publication details:

ISBN: 9781786043580 [Buy a hard copy of this report]

HC: 1131, 2019-21

Published date: February 10, 2021