An updated list of patients eligible for Covid treatments because they are most at risk of the disease has been published by an independent advisory group.
It has extended Covid treatments to individuals with any T-cell malignancy and respiratory conditions including patients taking immunosuppressants for asthma, those with COPD on long term home ventilation, and interstitial lung disease.
The update also includes several neurological disorders, including Duchenne muscular dystrophy and dementia or neurodegenerative disorders with severe frailty including Alzheimer’s, vascular disease, Lewy Body disease, frontotemporal atrophy, and Parkinson’s Disease.
It adds to the first recommendations made in May 2022 to support the use of antivirals and monoclonal antibody treatments after a review of more recent evidence on the groups most at risk from Covid infection.
Highlighting the changes in a primary care bulletin, NHS England said Covid Medicine Delivery Units will contact most patients if they test positive.
But as before, patients above may need a referral from GPs using the electronic Referral Service or alternative.
By the end of June, responsibility for the provision of Covid medicines will transfer to ICB control with locally agreed pathways put in place.
But GPs have raised concerns that vulnerable patients may struggle to access Covid treatments in time under the plans.
A letter to ICBs from NHS England said expectation was that ‘potentially eligible individuals will need to contact local NHS services when they test positive, rather than being contacted proactively’.
ICBs will need to put arrangements in place to ensure equitable access for hard to reach groups, it said.
It follows guidelines published by NICE at the end of March on Covid-19 treatments, which set out NHS recommendations for antivirals and monoclonal antibodies including nirmatrelvir plus ritonavir (Paxlovid), sotrovimab and tocilizumab.
Central stocks of Paxlovid and sotrovimab will be made available to the NHS free of charge ‘until stocks are exhausted or exceed their expiry dates’, ICBs have been told.
It is estimated there is enough supply of Paxlovid for two years, and enough sotrovimab for the next 6-12 months, NHS England said.
Officials have also announced an end to all PCR Covid testing outside NHS settings this month, alongside routine asymptomatic testing of patients and staff across all parts of health and social care.
The UK Health Security Agency said the changes would ensure testing continues to focus on those at highest risk, enables appropriate clinical treatment and supports the management of outbreaks in high-risk settings.
