Shielding: Government Advice For Those Needing To Shield

The Government has advised all those who are clinically vulnerable and who have previously shielded that they should resume shielding as part of the National Lockdown that commenced on Tuesday 5 January 2021. As yet, the government haven’t produced specific advise on shielding during this period, instead they have referred people back to the advice they were offering those in Tier 4 of the coronavirus restrictions. We have edited the government’s advice (which you can read in full here) to focus on these specific items of advice (i.e. Tier 4 restrictions) which are now relevant for the whole of England. There is also an easy read version of this advice here.

Coronavirus Advice: Shielding in Lockdown 3

If you are clinically vulnerable, you could be at higher risk of severe illness from coronavirus. There is additional advice for people who are clinically extremely vulnerable to coronavirus. Those who are clinically extremely vulnerable should follow resumed shielding guidance and should not attend work, school, college or university. You should limit the time you spend outside the home. You should only go out for medical appointments, exercise or if it is essential.

Who this guidance is for

This guidance is for everyone who has been identified as clinically extremely vulnerable. If you are in this group, you will previously have received a letter from the NHS or from your GP telling you this. You may have been advised to shield in the past.

Shielding

Further support will be made available from your local council and community pharmacies to help protect you during this period of heightened risk.

Work

You are strongly advised to work from home because the risk of exposure to the virus in your area may be significantly higher. If you cannot work from home, then you should not attend work.

You may want to speak to your employer about taking on an alternative role or change your working patterns temporarily to enable you to work from home where possible.

If you cannot make alternative arrangements, your employer may be able to furlough you under the Coronavirus Job Retention Scheme, which has been extended until the end of April 2021. You should have a conversation with your employer about whether this is possible.

As you are being advised not to attend work, you may be eligible for Statutory Sick Pay (SSP) or Employment Support Allowance (ESA). The formal shielding letter you receive will act as evidence for your employer and the Department of Work and Pensions that you are advised to shield and may be eligible for SSP or ESA.

Members of the household who are not clinically extremely vulnerable should continue to attend work if they are unable to work from home

Socialising

You can go outside, but try to keep all contact with others outside of your household to a minimum, and avoid busy areas. Outdoors, you can only meet one person from another household.

You are advised to stay at home as much as possible.

You can still remain in your support bubble, but you cannot meet with friends and family you do not live with unless they are part of your support bubble. This is part of the wider regulations in place in your area.

Try to stay 2 metres away from other people within your household, especially if they display symptoms of the virus or have been advised to self-isolate.

Travel

You are advised to stay at home as much as possible and not to travel unless essential.

Shopping

You are advised not to go to the shops. Use online shopping if you can, or ask others to collect and deliver shopping for you (friends and family, or NHS Volunteer Responders).

You can register to request access to priority supermarket deliveries, if you do not have someone you can rely on to go shopping for you. If you already have a priority delivery slot with a supermarket, that will continue – you do not need to do anything further. When registering you will be asked for your NHS number. You can find it on any letter the NHS has sent you, or on a prescription.

Registering on the site just gives you priority. It does not mean you’ll definitely get a delivery slot. If you want access to priority supermarket deliveries, you will also need to set up an account with at least one supermarket and book slots yourself.

If you need other forms of help, including support to register for a priority supermarket delivery slot, you should contact your local council directly. Find out how your local council can help.

Medicines

You are strongly advised not to go to a pharmacy because the risk of exposure to the virus is significantly higher in your area.

In the first instance, you should ask if any friends, family or volunteers can collect medicines for you.

If friends and family are not able to collect your medicines for you, and you and/or the pharmacy are unable to arrange a volunteer, then you will be eligible for free medicines delivery. Please contact your pharmacy to inform them that you are clinically extremely vulnerable and need your medicines delivered, and they will arrange this free of charge.

Care and support

You can still receive informal care at home from people within your support bubble.

You can still receive care at home from professional social care and medical professionals.

If you need additional help to follow this guidance, your local council may be able to help. If you are advised to shield you will be able to register yourself or someone else to:

  • request access to a priority supermarket delivery slot (if you have already got priority supermarket deliveries, you will keep them)
  • tell your council if you need support to follow shielding guidance, especially if you are unable to arrange this yourself or with the help of friends, family or other support networks
  • make sure your details, such as your address, are up to date

When registering you will be asked for your NHS number. You can find it on any letter the NHS has sent you, or on a prescription. It is helpful if you register even if you do not have any support needs at this time. You can log in and update your needs if circumstances change at any time.

Mental Health

It is also important to look after your mental health. Go to the Every Mind Matters website for advice and practical steps that you can take to support your wellbeing and manage your mental health during this pandemic. Visit our Mental Health support page.

If you or someone you care for are experiencing a mental health crisis, we urge you to make contact with a local health professional immediately.

General advice for clinically extremely vulnerable people

These are additional precautions to protect yourself.

Socialising inside and outside the home

  • Continue to maintain strict social distancing, wash your hands regularly and avoid touching your face.
  • Try to keep the number of social interactions that you have low. The fewer social interactions you have, the lower your risk of catching COVID-19.
  • Avoid gatherings with large numbers of people, especially indoors, because it significantly increases the risk of viral transmission.

Your risk of catching COVID-19 is lower if you meet people outdoors. If you meet indoors, keep the area well ventilated with fresh air, for example by opening the window. You can also go out and exercise in an outdoor public place; further information on how you can keep fit and healthy is available. Continue to observe strict social distancing with anyone outside of your household or support bubble. The more you socially distance from others, including your own household, the less likely you are to catch COVID-19. You should always stay at least 2 metres away from other people visiting your home.

Try to reduce the amount of time you spend in settings where you are unable to maintain social distancing, or where other people’s activities may reduce the likelihood of individuals maintaining social distancing.

If you require additional care and support

It is important that you continue to receive the care and support you need to help you stay safe and well. Providers of social care and medical services are making every effort to ensure services remain open and as safe as possible (visit Calderdale Council’s website)

You should continue to seek support from the NHS for your existing health conditions. You can access a range of NHS services from home, including ordering repeat prescriptions or contacting your health professional through an online consultation. To find out more visit Health at Home, or download the NHS App. If you have an urgent medical need, call NHS 111 or, for a medical emergency, dial 999.

Any carers or visitors who support you with your everyday needs can continue to visit. They should follow social distancing guidance where close or personal contact is not required.

If your carer is a paid carer visiting you in your home, they will find information on the provision of home care and personal protective equipment (PPE) in the provision of home care guidance and PPE for care workers delivering homecare guidance. If you receive unpaid care, your carer should refer to the Guidance for those who provide unpaid care to friends or family.

You should continue to access support from local charities and organisations, as well as NHS Volunteer Responders. As well as helping with shopping and medicines delivery, NHS Volunteer Responders can help with a regular, friendly phone call, either with someone else who has previously been advised to shield or with different volunteers and transport to medical appointments.

Call 0808 196 3646 between 8am and 8pm to arrange support or visit NHS Volunteer Responders website. Speak to your health care professional to arrange transport support.

Definition of clinically extremely vulnerable groups

People who are defined as clinically extremely vulnerable are at very high risk of severe illness from coronavirus. There are 2 ways you may be identified as clinically extremely vulnerable:

  1. You have one or more of conditions listed below, or
  2. Your clinician or GP has added you to the Shielded Patient List because, based on their clinical judgement, they deem to you be at higher risk of serious illness if you catch the virus.

If you do not fall into any of these categories, and have not been contacted to inform you that you are on the Shielded Patient List, follow the general staying alert and safe guidance for the rest of the population.

If you think there are good clinical reasons why you should be added to the Shielded Patient List, discuss your concerns with your GP or hospital clinician.

People with the following conditions are automatically deemed clinically extremely vulnerable:

  • solid organ transplant recipients
  • people with specific cancers:
    • people with cancer who are undergoing active chemotherapy
    • people with lung cancer who are undergoing radical radiotherapy
    • people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
    • people having immunotherapy or other continuing antibody treatments for cancer
    • people having other targeted cancer treatments that can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
    • people who have had bone marrow or stem cell transplants in the last 6 months or who are still taking immunosuppression drugs
  • people with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD)
  • people with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell disease)
  • people on immunosuppression therapies sufficient to significantly increase risk of infection
  • problems with your spleen, for example splenectomy (having your spleen removed)
  • adults with Down’s syndrome
  • adults on dialysis or with chronic kidney disease (stage 5)
  • women who are pregnant with significant heart disease, congenital or acquired
  • other people who have also been classed as clinically extremely vulnerable, based on clinical judgement and an assessment of their needs. GPs and hospital clinicians have been provided with guidance to support these decisions