NHS England published this guidance on Saturday 13 February which offers some more detail about eligibility for cohort 6 (age 16-65 years with underlying health conditions). We have now released v3.8 of the Ardens COVID-19 Vaccination Searches which include the following revisions:
- Asthma searches now aligned as closely as possible with NHS England cohort 6 guidance published on Sat 13 Feb.
The Ardens searches now identify asthmatics who have EVER HAD an emergency hospital admission and those prescribed at least 3 COURSES of oral steroids in the previous 12 months.
- Congenital Heart Disease searches now exclude patients coded with an atrial-septal defect or ventricular-septal defect and no other coded heart condition.
Previous versions of the Ardens searches included these patients. The Green Book is not clear on the definition of "congenital heart disease" but it is reasonable to assume the intention was not to include patients with an ASD or VSD as a baby who are now otherwise well.
- Several other clinical codes have been removed to improve accuracy.
Examples include "sinus bradycardia" and "sinus arrhythmia" which were accidentally included in previous versions.
We are confident that our searches are very accurate. It is ESSENTIAL, however, that users of the Ardens cohort 6 searches understand that these have had to be built manually based on nothing more than a few lines of text from The Green Book. They contain thousands of clinical codes and there will be some patients identified incorrectly. Whichever provider of COVID-19 searches that you choose to use will have the same problem as there is no published code-list for cohort 6.
Please note that the EMIS alert in the pink "alert box" advising which cohort a patient is in does not currently work correctly for cohort 6 and should be ignored.
The Green Book states that when considering eligibility for cohort 6 "the prescriber should apply clinical judgment to take into account the risk of COVID-19 exacerbating any underlying disease that a patient may have, as well as the risk of serious illness from COVID-19 itself". Clinicians therefore have the freedom to add patients into cohort 6 who they feel clinically should receive a vaccination in this cohort. Please review this message that I sent on 4th February that explains how to do this (and also how to filter our reports to produce customised lists of patients).
Downloading COVID-19 Vaccination Searches
We have made all of the Ardens COVID-19 resources available to any GP practice (including non-subscribers) free of charge. Please download "1.7 COVID-19 Searches" via www.ardens.live/portal (create a free account first if you don't already have one).