Recommendation 14

NHSE&I was not responsible for managing any local variations and did not challenge local clinical decisions.28 DHSC has told us that NHSE&I and NHS Digital considered that ultimately additions were a decision for local clinicians. It noted that the approach to local additions was endorsed by the UK Chief Medical Officer who provided guidance on 18 Q 21; C&AG’s Report, paras 12, 2.5 19 Qq 21–22 20 Q 21; C&AG’s Report, para 2.6 21 C&AG’s Report paras 2.5, 2.10 22 SVL0002 - Written Evidence submitted by Asthma UK and the British Lung Foundation p.3 23 C&AG’s Report, para 2.6 24 Qq 23–24 25 Qq 21–22, 97–98 26 Qq 21, 23, 25; C&AG’s Report, para 2.6 27 C&AG’s Report, Figure 8, analysis of underlying data 28 C&AG’s Report, para 2.9, Figure 8 Covid 19: supporting the vulnerable during lockdown 11 the shielded patient list. DHSC also explained to us how NHSE&I and NHS Digital took steps to try to ensure this process was consistently applied across England. For example, it told us how on 12 April NHS Digital noticed that additions by GPs showed wider than expected variation and identified that GPs were adding patients in bulk using computer searches rather than assessing individual patients. In response, NHSE&I told GPs that there should be no automated process used to compliment or supplement individual clinical identification.29