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The Government’s Covid-19 shielding scheme was “quickly drawn up” and “suffered from the problems of poor data and a lack of joined up systems” according to a Public Accounts Committee report.
The report also found that there was no pre-existing plan for shielding the clinically vulnerable and the government “took too long to identify some clinically vulnerable people at a time when their need was urgent”.
This meant that up to 800,000 people may have slipped through the net and missed out on much-needed support.
In its summary, the committee said that the Government quickly drew up plans to identify and support some 2.2 million people at the greatest risk from Covid-19 with food, medicines and basic care with £308 million spent on the programme.
High human cost of the lack of planning for shielding
The purely clinical approach to vulnerability omitted key characteristics such as ethnicity, postcode and Body Mass Index (BMI). As a result of its newly expanded approach, it classified an additional 1.7 million people as clinically extremely vulnerable in February 2021 and they were advised to shield as a result.
Meg Hillier MP, Chair of the Public Accounts Committee, said the shielding response in the Covid pandemic has particularly exposed the high human cost of the lack of planning for shielding in pandemic planning scenarios. It also highlights the perennial issue of poor data and joined up policy systems.
She added: “People were instructed to isolate, to protect themselves and others – but the cost of this protection was reduced access to living essentials like food, and an untold toll on the mental health and well-being of the already most vulnerable. There are questions still to be answered about the balance between central decision making and local knowledge; the increase in numbers of those advised to shield demonstrate the challenges of trying to deliver this programme centrally, as well as with the data held by the NHS.
“Plans were eventually, sensibly devolved to local authorities. There needs to be a clear plan ahead for those with serious health conditions so they can access the support they need when they have no other support network.”
Unclear communication jeopardised the health of the public
BMA council chair Dr Chaand Nagpaul said that throughout this pandemic, it has been some of the most vulnerable people who have been the most disproportionately impacted and the disjointed and unclear shielding guidance has been a factor in this.
“Had we been better prepared ahead of the pandemic, the shielding lists could have been created more quickly and effectively rather than shifting criteria and suddenly increasing the number of people on the list,” he said. “At a time when GPs were already overwhelmed, this led to a huge rise in workload having to contact large numbers of people within a short time frame without comprehensive guidance.
“In what was already an incredibly stressful time for patients, unclear communication from the Government and repeated changes to guidance made this a much more distressing and difficult experience, jeopardising the health and wellbeing of the public.”
The BMA added that it was important that any future planning should be informed by better engagement with disabled and vulnerable people to understand how their needs can be considered and how best to accommodate this.