The UK-wide Networked Data Lab (NDL) is a collaborative network of analytical teams across the UK working together using linked datasets on key issues facing health and care services today. Its latest research reveals a devastating and lasting impact of the pandemic on those asked to shield. The NDL aims to provide health system leaders with insights that improve the UK’s health system, create an active community of data analysts working together on shared challenges, and promote the use of analytics in improving health and social care. Partners in the NDL include;
- The Aberdeen Centre for Health Data Science (ACHDS) which includes NHS Grampian and the University of Aberdeen
- Population Data Science at Swansea University (SAIL Databank and SeRP), Public Health Wales, Digital Health and Care Wales, and Social Care Wales (SCW).
- Imperial College Health Partners (ICHP), Institute of Global Health Innovation (IGHI), Imperial College London (ICL), and North West London CCGs
- Liverpool CCG and Healthy Wirral Partnership
- Leeds CCG and Leeds City Council
During the summer, Population Data Science reported on the networked Data Lab (NDL) Wales component of this UK analysis. Published in a Public Health Wales report, that saw declining rates in hospital admissions amongst the 127,000 people in Wales who were asked to shield during COVID-19. The report highlighted increasing health inequalities – with those who have the greatest health care needs least likely to receive it.
NDL Wales used anonymised health records available in SAIL Databank underpinned by Trusted Research Environment (TRE) provider, SeRP – the Secure eResearch Platform.
This UK report from The Health Foundation reveals the extent to which the pandemic has impacted on the more than four million people asked to shield across the UK. The analysis suggests that there is now significant unmet health need and worsening mental health among this group.
Key findings of the report:
- The rate of deaths among the shielded population was over two and half times that in the general population (1 in 2,500 compared to 1 in 7,000)
- By the end of August 2020 in England, the shielded population accounted for 19% of all deaths while only making up 4% of the total population.
- Planned hospital admissions for shielding people decreased by 51% while outpatient appointments decreased by 48% due to NHS restructure to deal with COVID-19.
- Although there was no intentional reorganisation of emergency care, emergency admissions for shielded people decreased by 32% from April 2019 to April 2020, while A&E attendances decreased by 42%.
- In Wales, shielded individuals were at increased risk of depression and/or anxiety; From March to September 2020, 1 in 50 shielded people were clinically recorded with depression and/or anxiety during shielding – 1 in 5 of those had no previous history.
- There were significant issues in the way that the shielding patient list was compiled that resulted in classification variations across the UK relating to methodology and data quality inconsistencies.
Based on the findings, the Health Foundation says action is now needed by those planning the pandemic recovery at local and national level to better understand the needs of their shielding populations and ensure that their needs are prioritised. The authors say that greater access to data from general practice and better data sharing aids identification, and that investment in data sharing and data quality will be essential to improving the process.
Kathryn Marszalek, Senior Analytical Manager at the Health Foundation, said:
‘Action is now needed by those planning the recovery at local and national levels to address the unmet need for NHS care and worsening mental health. Failure to prioritise the needs of the clinically extremely vulnerable population will inevitably result in further deterioration in their health, putting additional pressure on the NHS which is already struggling to deal with a massive backlog of care. Alongside this immediate support, further work is needed to understand the longer-term consequences for the clinically extremely vulnerable population, both in terms of long-term health care needs but also in terms of their ability to resume work and other daily activities. But this will be complicated by the current lack of high-quality data across the health and care systems. Further investment is urgently needed to ensure that in the event of a future health emergency, we can quickly, accurately and consistently identify individuals to enable rapid planning and delivery of relevant support.’
The Health Foundation’s full report can be found here – https://www.health.org.uk/publications/reports/assessing-the-impact-of-covid-19-on-the-clinically-extremely-vulnerable-population