Study population
The number of people identified as eligible for shielding in Wales was extracted from the data source of the Coronavirus Shielded Persons (CVSP) list within the SAIL databank. [13]which was provided by Digital Health and Care Wales (DHCW) based on an agreed methodology for people identified as shielding. [14]. In response to the coronavirus disease (COVID-19) outbreak, the so-called “C20 Cohort” is a population-level was created to provide electronic data resources for. [11]. His CVSP data within SAIL was used to identify persons within the C20 cohort who were officially recognized as shielding persons. The shielded population used in this study includes the following people: i) People identified on the CVSP list ii) People with a valid date of addition to the list iii) People added during 2020 [the enrolment period] iv) no death date before March 23, 2020, and v) records corresponding to the C20 cohort. A more detailed explanation of how to extract data from SAIL can be found elsewhere. [15]. The costs associated with implementing the shielding policy in Wales were only available for the entire supported population. A breakdown of costs for different cohorts with specific conditions was not available.
Resource components of shielding interventions
The resource components of shielding interventions for people with CEV in Wales during the early stages of the COVID-19 pandemic were mapped using a public sector perspective and based on public reports produced by the Welsh Government. [16]. Search for documents and webpages related to the management of coronavirus disease (COVID-19) classified as vulnerable and advised to stay at home for the first 14 weeks from March to June 2020 We asked for relevant information on strategies and advice put in place to support people. Where public information about the provision of a service or associated costs is not available, a Freedom of Information (FOI) request may be submitted to the Welsh Government and personal communications (e.g. from the Office of the Chief Medical Officer of Wales or Digital Healthcare (with staff) was used. To fill in information gaps where necessary.
It is based on a logical model of a shielding program developed by the research team during the early stages of work on the EVITE program. [17]four main components of the shielding intervention were identified and unit costs were assigned as follows:
Component 1: Cost of creating a shielded patient list
The CVSP list was created by Digital Health and Care Wales (formerly NHS Wales Informatics Service, NWIS) with additional staff time provided by NHS Wales Delivery Units (DUs) and advice from Public Health Wales. [14]. These NHS central bodies carried out two additions to the Wales Protected Patient List, with general practitioners (GPs) identifying nearly 13,000 additional patients.
Secondary care clinicians can also notify general practitioners if they feel a patient should be added to the list. However, it is possible that some secondary care clinicians may have written directly to patients and, as a result, these patients may not have been added to the protected patient list. [18]. From 25 May 2020, the Chief Medical Officer of Wales (CMO) will require secondary care providers to ensure that patients identified in secondary care are sent to Digital Health and Care Wales for testing. He directed that the letter be collated by the health committee before being sent to the government, after which the letter should be issued centrally. General practitioners continued to provide updated patient lists weekly as before. By May 2020, around 130,000 patients had been identified as shielding across Wales. [18].
Email and online audiovisual interviews with staff from relevant organizations and the Wales CMO Office were used to estimate the costs of this first part of the shielding intervention.
Component 2: Cost of contact with people advised to shield
NHS Wales Shared Services Partnership (NWSSP) provided administrative support to people identified as protected between March and June 2020 to manage mailings from protection letters. The first letter was sent on behalf of her CMO in Wales on 24 March 2020. This was followed by a letter from the Local Government Council a week or two later and another letter on behalf of her CMO in Wales in June 2020. Due to the lack of information available, it was believed that all three of her letters were sent to everyone on the CVSP list. The administrator’s mail processing time (printing, collating, and folding letters into envelopes) was estimated to take him 2 minutes per letter. Rates for letter materials were obtained online from independent office he suppliers, calculating staff time costs based on hourly rates for band 3 and 4 management roles. [19].
Component 3: Pharmacy delivery costs
The Welsh Government provided two schemes to support the delivery of medicines to people in protection during the first wave of the pandemic: the National Volunteer Prescription Delivery Scheme and the Royal Mail Truck 24 Click and Drop Scheme. [20]. A Freedom of Information request has been submitted to the Welsh Government to obtain information about the cost of these schemes. [21, 22].
National prescription delivery system
The National Volunteer Prescription Delivery Scheme was announced by the Welsh Government Minister for Health and Social Care on 5 May 2020. Volunteers were recruited by the British Red Cross and St John Ambulance Simle. In addition, Welsh Government officials have recruited volunteers from among furloughed staff, working with pharmaceutical manufacturers, the Welsh Optometric Authority, the Driving and Vehicle Standards Authority and various Welsh Government departments. Additionally, individuals in the public sector who have had their day-to-day duties reduced and have appropriate disclosure and prohibition service authorization can contact Welsh Government directly to request volunteering.
Pro Delivery Manager Software Cost
As part of the National Prescription Delivery Plan, a logistics software package called Pro Delivery Manager (PDM) was installed in community pharmacies and dispensing general practices in Wales to support delivery route planning and scheduling for medicine deliveries. [23].
Royal Mail Track 24 Click and Drop Scheme
In May 2020, the Welsh Government also introduced the Royal Mail scheme to support patients who are unable to deliver via the National Prescription Delivery Scheme. Royal Mail’s commercial service delivered the goods through its Track 24 service, in which postmen pick up prescription drugs from local pharmacies, fill them in general practices and deliver them to patients the next day.The cost of this service was obtained through a Freedom of Information request [21].
Funding for prescription dispensing
From April 2020, all pharmacies and dispensing general practices that have confirmed with their health board that they have arrangements in place to support patients who have no other means of collecting their medicines will be required to An additional charge of 7.4 pence was to be paid. [24]. This funding was applied to all items dispensed and was recycled from the core contract payments to pharmacies and GP practices, ‘Global Sum’. These payments would have previously been used to provide medicine utilization reviews that have been suspended during the pandemic (personal communication via email with Community Pharmacy Wales, dated 16 April 2021).Data extracted from the SAIL databank via the Wales Dispensing Dataset (WDDS) [25] It was used to estimate the number of prescriptions filled during a 14-week quarantine period from April to June 2020 for people included on the CVSP list.
Component 4: Local government free food box scheme
In early April 2020, the Welsh Government launched a national food box scheme. [26]. This was provided to sheltered individuals who did not have family or friends nearby or access to the internet or the means to pay for food. These funds were intended to supply food parcels designed to nutritionally support one person for her week over the initial shielding period. The funding made available was based on an estimated 30% utilization of the scheme.Funding for the food box scheme was provided by the Welsh Government through a Freedom of Information request. [27].
In addition to free food boxes, shielders were also offered priority food delivery slots by eight of Wales’ leading supermarket chains who can offer home delivery. These supermarket priority food delivery slots were not immediately available at the start of lockdown, but will become widely available in the middle of the shield period when pressure on the Welsh Government’s food box scheme has eased. I did. This allows people who have been identified as shielding and who have the means and financial means to order their own food without leaving their homes. The costs incurred by private supermarkets to realize this scheme are excluded from this assessment.
Research management and social participation
The EVITE Immunity research team included clinical, policy, academic, methodological, and public contributor experts who were equally responsible for all decisions to develop, manage, and conduct this study. . Two public contributors were co-applicants and members of the study management group, and in addition, she worked with six individuals to provide extensive public input through a patient advisory committee. The independent research steering committee included him and two general contributors. Our general contributors and some academic co-applicants have been personally affected, directly or indirectly, by the implementation of the shielding policy. [28, 29].
