Population Health: COVID-19 Treatment Methodology
Treatment options are available for some people who have tested positive for coronavirus (COVID-19). From 16 December 2021 to 26 June 2023, NHS Digital provided the technology to support the NHS to identify patients eligible for the drugs.
Members of the public looking for more information about treatments for COVID-19, visit the NHS website.
The former Deputy Medical Officer, Professor Jonathan Van Tam commissioned a clinical expert group led by Professor Ian McInnes. The group were to deliver a set clinical condition identifying those people most at risk of developing the severe effects of COVID-19 infection within the current vaccinated population of the UK.
NHS England developed the clinical policy for the neutralising monoclonal antibodies and antivirals treatments for COVID-19.
They commissioned the creation of a digital rule logic, based on the clinical policy to identify people within England, with a positive COVID-19 PCR or LFT (Lateral Flow Test), who are at most risk of developing severe complications of COVID-19 infection.
This would enable these people to receive treatment at early disease stage in the community, reducing the risk of worsening disease and hospital admission.
Centrally held patient data is used to identify people who may be at high risk of COVID-19 complications. These people may not be able to gain the full benefit from immunisation, due to an inability to launch a full immune response to COVID-19 vaccination.
The cohorting rule logic will enable people at risk of severe complications due to COVID-19 infection to be treated at an early disease stage in the community, reducing the risk of worsening disease and hospital admission.
Generally, an inclusive approach has been used, where nuanced data is not available for people to be included, or excluded for treatment at the point of telephone clinical triage.
Where patients are not able to be identified digitally, a non-digital pathway is available.
Changes in policy prior to April 2023 have been reviewed and reflected in the digital rule set.
The details of any changes following the initial release of the service are summarised below.
Changes to digital identification of patients April 2022
In April 2022, additional rule logic was implemented to expand digital coverage of the clinical policy. These changes were made to improve digital identification of:
- individuals with haematological malignancies receiving systemic anti-cancer treatment (SACT) within the last 12 months, with chronic phase chronic myeloid leukaemia (CML) in molecular response or first or second line tyrosine kinase inhibitors (TKI)
- patients with chronic kidney stage (an eGFR less than 30 ml/min/1.73m2) CKD4 or CKD5
- myelodysplastic syndrome (MDS)
Changes to digital identification of patients updated policy published 30 May 2022
An updated version of the defining the highest-risk clinical subgroups upon community infection with SARS-CoV-2 when considering the use of neutralising monoclonal antibodies (nMABs) and antiviral drugs: independent advisory group report was published on 30 May 2022.
Following this publication, the rule logic has been reviewed and updated to ensure alignment to the policy and improvement to the digital identification of patients.
These changes include:
- radiotherapy being increased from 6 months to 12 months
- all chemotherapy increased to 12 months
- a 6-month post treatment window for people who have received Cyclophosphamide
They also include the addition of:
- chromosomal and genetic disorders affecting immune competence
- CMML (chronic myelomonocytic leukaemia)
- myelofibrosis
- corticosteroid dosing definition
- current azathioprine monotherapy
- people on current methotrexate monotherapy (for ILD only)
Updated policy published 31 March 2023
The decision has been made not to make any further changes to the digital cohorts at this time.
Last edited: 28 June 2023 12:11 pm