Background

Ethnicity is a risk factor for COVID-19. The pandemic has also highlighted (and in some instances exacerbated) existing inequalities in healthcare provision and outcomes for BAME communities.

NHSE&I committed, as part of the third phase of the NHS response to COVID-19, to ensure that people who may be clinically extremely vulnerable to infection, including those of BAME ethnicity, are supported through the second wave of the pandemic. The letter also set out an ambition to restore services inclusively so that they are used by those in greatest need. This will be guided by new core performance monitoring of service use and outcomes among those from Black and Asian communities.

National and practice-level risk stratification models and performance monitoring of services rely on ethnicity data drawn from Primary Care Patient Records but this is not comprehensively recorded. We estimate that only around 65% of the population hold a recording of ethnicity in their Primary Care Record. NHS Digital holds a combined Primary/Secondary Care patient-level data set which provides coverage for c.88% of the population.

If we do not act to improve this position, we will limit our ability to accurately risk stratify, target and monitor care by ethnicity. Longer-term work is underway to ensure that ethnicity is collected as standard in general practice. A related national programme is focusing on the quality of data held. Neither will be delivered in time to inform our response to, or monitoring of the second wave.

Outline Plan

We propose to:

Use the COVID Ethnic Category Release data, held by NHS Digital to:

• Identify where this data set holds ethnicity data for Patients that is not held in GPIT systems.

• Directly code this ethnicity data into only these records. N.B. there is no ‘overwrite’ of existing GP-held data in this option.

• Provide a ‘flag’ in clinical systems for GPs to check the accuracy of this data with the Patient at the next available opportunity.

Delivery date: Early 2021

Summary of Change

Relevant clinical records need to be updated with ethnicity data from the combined data set; taking the proportion of Primary Care records with a recording of ethnicity into line with the proportion in that data set – currently c.88% of the total population.

Full Specification

TBC

Assurance Approach

TBC