Characteristics of those on the shielding patients list identified using National Survey for Wales data: April 2018 to March 2019

• 1 in 7 (14%) of people on the Shielded Patient List (SPL) were in material deprivation based on the 2018-19 National Survey for Wales (NSW).
• 87% of people on the Shielding Patients List had household access to the internet compared to 93% of those not on the SPL.
• The majority of people on the Shielding Patients List were able to keep up with bills and commitments without any difficulties in 2018-19
• The mental wellbeing of people on the Shielding Patients List was similar to those not on the list when asked in the 2018-19 NSW.

For this analysis we linked NSW data with the Shielding Patients List (SPL) dataset as at 24 February 2021 to explore whether people who were on the SPL due to their being identified as clinically extremely vulnerable also had other non-clinical vulnerabilities. The NSW provides data on a range of characteristics, such as material deprivation, Welsh language ability, loneliness and wellbeing. 

An analysis of the SPL by area and age is available. Generally, the SPL has a higher percentage of people in older age groups than the population of Wales as a whole. The different age profile of those on the SPL compared with those not on the SPL may be driving some of the trends in this analysis.

In the NSW questions on material deprivation are used to provide a measure of poverty and long-term effects on households. For example, questions cover whether people are able to afford to keep their homes warm enough or make regular savings. These questions are asked to allow cross analysis of other topics on the survey by material deprivation, and so understand better the circumstances of materially deprived people in Wales.

In this analysis, material deprivation is explored in the context of whether people were advised to shield due to the COVID-19 pandemic.

Overall, 1 in 7 (14%) of people on the SPL were in material deprivation when responding to the NSW before the pandemic (compared to 14% overall). When broken down by age, amongst non-pensioner adults on the SPL who were also in the NSW, 1 in 5 (21%) were in material deprivation (compared to 17% of those not on the SPL). Furthermore, amongst pensioners on the SPL, 6% were in material deprivation in the NSW (compared to 4% of those not on the SPL). For context, 8% of pensioners and 17% of non-pensioners living in Wales were in material deprivation in 2018-19 (for further information see 'National Survey for Wales headline results: April 2018 to March 2019'). Our estimates may differ to published estimates due to our data linkage matching success.

As our analysis is based on survey data we have presented the confidence intervals as well as the point estimates. The point estimates suggest a larger percentage of shielding people experienced material deprivation in 2018-19 than non-shielding people. However, due to the confidence intervals overlapping for the two groups the differences are not statistically significant. This may be because there were no differences in levels of material deprivation between the two groups or because our sample size is not large enough to detect a ‘true’ difference.

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Chart 2 explores the percentage of people on the SPL who were able to keep up with their household bills in 2018-19. The majority of people were able to keep up with all bills and commitments in 2018-19 without any difficulties, regardless of whether they were included on the SPL in 2020-21. Any differences between shielded people and those not shielding are not statistically significant. Note that some categories are missing due to low sample counts that may risk disclosure.

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In 2018-19 when people who are now on the SPL were asked if they had household internet access, 86.8% said they had access. This is a smaller percentage (93.4%) than those not on the SPL.

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The Warwick-Edinburgh Mental Well-being scale (WEMWBS) is used to monitor the mental wellbeing of people. Our analysis of 2018-19 data found that there was little difference between people shielding and those not shielding. A mean score of 50 for shielding people was slightly lower than for those not shielding (51), but these differences are not statistically significant. According to the WEMWBS scale, a score of 45-57 is considered as medium wellbeing.

Shielding people were found to be slightly more anxious and felt less happy and worthwhile than people not shielding, though these differences are not statistically significant. Shielding people were slightly less likely to be satisfied with their lives than people not shielding, though again, this difference was not statistically significant.

Analysis was also undertaken on 2017-18 NSW data to investigate loneliness. The NSW asked whether people felt lonely. We found that 30% of those shielding were not lonely in 2017-18. Please note, the variables used to calculate confidence intervals and to weight the estimates were unavailable for this year. Therefore, the quality of these estimates may not be as robust as those produced using weighted estimates. We have also not been able to test for a statistically significant difference between shielding and non-shielding groups but because the difference between the two groups is very small, it is unlikely to be statistically significant.

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Questions on use and ability to speak Welsh form a core part of the NSW every year. In 2018-19 around 11% of people on the SPL spoke Welsh whilst around 15% had some Welsh speaking ability. However, people on the SPL were not more likely to speak Welsh than those who were not on the SPL.

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Similar percentages of people on the SPL were able to read or write Welsh (around 14%), with no significant difference between the shielding and non-shielding groups in both cases.

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The Administrative Data Research Unit (ADRU) in Welsh Government undertakes various data linking analyses, including those related to the COVID-19 pandemic. For this analysis, data from the Shielding Patients List was linked to data from the NSW in 2018-19 (2017-18 for the loneliness questions). The purpose of this was to determine whether those shielding were also materially or socially disadvantaged and whether there were implications for wellbeing and use of the Welsh language as a result of shielding policy.

A limitation of using NSW data is that because the data are collected through a survey, the dataset is based on a sample, rather than the whole population, therefore the results are estimates only. A further limitation is that data of interest from the NSW relate to an earlier period (2018-19 but 2017-18 for the loneliness questions) so people’s circumstances may have changed. Nevertheless, the analysis provides insight into characteristics of people on the SPL that would otherwise not have been possible.

Linking the two datasets gave us a sample size of 400 respondents to the 2018-19 NSW who were on the SPL and 1,200 respondents to the 2017-18 NSW who were on the SPL. Sample sizes for non-shielding were 4,500 for 2018-19 and 7,700 for 2017-18. The NSW involves around 12,000 people each year and covers a wide range of topics. It runs all year round, across the whole of Wales. The results are used by the Welsh Government to help make Wales a better place to live.

The SPL is derived using a variety of data sources drawn from the Health Service. It contains information on living patients classed as ‘high risk’ during the coronavirus pandemic and who have been advised to shield at various stages during the pandemic. This analysis used the SPL for Wales as at 24 February 2021. The data owners are NHS Wales Informatics Service (NWIS), and Unique Property Reference Number (UPRN) data based on address information was added by Geoplace. More information on the sources and methodology can be accessed on the NHS Wales Informatics Service. 

We applied statistical weights from the NSW datasets to adjust the results to represent the Welsh population. Survey weights are re-calculated each year so that for 2018-19 SAMPLEPERSONWEIGHT was used to weight the 2018-19 responses. People without a weight were removed from the analysis.

Confidence intervals act as a way of measuring the potential range of an estimate and are expressed as a lower confidence interval limit (LCL) and upper confidence interval limit (UCL). For this analysis, 95% confidence intervals were calculated. This means that 95% of the time when taking a sample of the population, we would expect the estimate to lie within the LCL and UCL. Overlapping confidence intervals were used as a measure of statistical significance in this article. If the intervals do not overlap, then the difference between two estimates is said to be statistically significant.

Confidence intervals were produced for all estimates, apart from the estimates for loneliness. They were produced using the SVY Proportion function in the statistical program Stata16, with local authority as a strata variable and SAMPLEADULTWEIGHT as the weighting variable.

The Warwick-Edinburgh Mental Well-being scale (WEMWBS) is used to monitor the mental wellbeing of people. The following scores are used to indicate different levels of wellbeing:

Low wellbeing (14 to 44)

Medium wellbeing (45 to 57)

High wellbeing (58 to 70)

Timeliness and punctuality

This analysis was undertaken with the most up-to-date SPL at the time of analysis in the Secure Anonymised Information Linkage (SAIL) databank and is regularly updated. Therefore, it would be possible to revisit the analysis if necessary. The cut-off period for the data was 24 February 2021.

Limitations

This analysis is limited to just those identified on the NSW datasets. Therefore, data is not available for everyone on the SPL. Weighted proportions were provided to help represent the SPL.

For data to be made available in the SAIL databank, people were required to give consent to their data being used for linkage purposes. Therefore, some records for people included in the NSW cohort were unavailable for linkage.

Not everyone that provided a response to NSW questions were linked successfully and therefore it was not possible to identify everyone that is not shielding in Wales.

Confidence intervals and weighted responses were not possible to achieve with 2017-18 NSW data due to the necessary variables being unavailable. These results should be treated with caution, especially when making comparisons between groups.

As some people have been added to the SPL since our cut-off of 24 February 2021 for the data we used, it is possible that some of these may have been included in our comparator for non-shielding people in the NSW.

Well-being of Future Generations Act (WFG)

The Well-being of Future Generations Act 2015 is about improving the social, economic, environmental and cultural wellbeing of Wales. The Act puts in place seven wellbeing goals for Wales. These are for a more equal, prosperous, resilient, healthier and globally responsible Wales, with cohesive communities and a vibrant culture and thriving Welsh language. Under section (10)(1) of the Act, the Welsh Ministers must (a) publish indicators (“national indicators”) that must be applied for the purpose of measuring progress towards the achievement of the Well-being goals, and (b) lay a copy of the national indicators before Senedd Cymru. The 46 national indicators were laid in March 2016 and this release refers to four of the national indicators namely 19, 29, 30 and 37.

These are the percentage of people:

• living in households in material deprivation (No 19)
• who are lonely (No 30)
• can speak Welsh (No 37)

Also referenced is:

• mean mental wellbeing score for people (No 29)

Information on the indicators, along with narratives for each of the wellbeing goals and associated technical information is available in the Wellbeing of Wales report.

As a national indicator under the Act they must be referred to in the analyses of local wellbeing produced by public services boards when they are analysing the state of economic, social, environmental and cultural wellbeing in their areas.

Further information on the Well-being of Future Generations (Wales) Act 2015.

The statistics included in this release could also provide supporting narrative to the national indicators and be used by public services boards in relation to their local wellbeing assessments and local wellbeing plans.

This research has been carried out as part of the ADR Wales programme of work. The ADR Wales programme of work is aligned to the priority themes as identified in the Welsh Government’s national strategy: Prosperity for All. ADR Wales brings together data science experts at Swansea University Medical School, staff from the Wales Institute of Social and Economic Research, Data and Methods (WISERD) at Cardiff University and specialist teams within the Welsh Government to develop new evidence which supports Prosperity for All by using the SAIL Databank at Swansea University, to link and analyse anonymised data. ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (grant ES/S007393/1).

Statistician: Kathryn Helliwell
Telephone: 0300 062 8349
Email: adruwales@gov.wales

Media: 0300 025 8099

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SB 15/2021