Latest Government Letter/Advice For Clinically Extremely Vulnerable People

Part 1 – Letter

Important advice for clinically extremely vulnerable people during the national lockdown

On 4 January 2021, the Prime Minister announced a new national lockdown to help tackle the high and rising cases of COVID-19 across the country. Everyone is required to follow the new national restrictions, which include:
1. Requiring people to stay at home, except for specific purposes.
2. Preventing gathering with people you do not live with, except for specific purposes.
3. Closing certain businesses and venues, like hospitality and non-essential retail.
4. Support children and young people to learn remotely until February half term, except for vulnerable children and the children of critical workers who may still attend school.

The new national lockdown restrictions are rules that apply to everyone and which everyone must follow. The full details of these rules can be found online at gov.uk/coronavirus.

As part of the lockdown, the Government is also advising all clinically extremely vulnerable people to take extra shielding measures to protect themselves. This advice will apply until 21 February 2021. If the advice is to continue beyond that date, we will write to you again with further information. We are writing to you because you have previously been identified as someone thought to be clinically extremely vulnerable and therefore at highest risk of becoming very unwell if you catch COVID-19.

This letter contains important advice on how to protect yourself and how to access further support. It also includes specific advice for clinically extremely vulnerable children and young people. Whilst you are strongly advised to follow these extra precautionary shielding measures to help keep yourself safe, this remains advice, not the law. You must, however, follow the lockdown rules that apply to everyone.

If you live in an area that was previously in Tier 4, you may have recently received a letter advising you to shield. This letter now replaces that one, and you should follow the guidance and time periods set out in this letter.

Advice summary

Clinically extremely vulnerable people are advised to stay at home as much as possible. You can still go outdoors carefully to exercise or to attend health appointments. You are strongly advised to work from home if you can. If you cannot work from home, then you should not attend work. You may be eligible for the Coronavirus Job Retention Scheme (furlough). This letter is a formal shielding notification and can act as evidence for your employer to show that you cannot work outside your home from 5 January until 21 February 2021, including for statutory sick pay (SSP) purposes.

Please make sure your GP has your most up to date contact details, including your home address and, if possible, a personal email address, so that we can contact you quickly in the event that guidance changes in the future. If you need any additional support to help you follow the guidance, your local council may be able to help. You can contact your council and register for support at the Shielding Support website: www.gov.uk/coronavirus-shielding-support

Advice for clinically extremely vulnerable children and young people
Our current knowledge suggests that very few children are at highest risk of severe illness due to the virus. Doctors have therefore been reviewing all children and young people who were initially identified as clinically extremely vulnerable to confirm whether they are still thought to be at highest risk. If this letter is addressed to a child or young person, and you have not yet heard from your child’s hospital doctor or GP to discuss this, please contact whoever usually provides care for your child to check whether they should still be considered clinically extremely vulnerable. If you have already discussed this with your child’s doctors and they have confirmed your child is still considered clinically extremely vulnerable, they should follow the advice in this letter.

Access to health and care
Please remember that the NHS is open, and we urge you to continue to access all the NHS services that you need. It is safer for you to use the NHS than to try to manage alone. If you are concerned about the impact of COVID-19 on your health, speak to your GP, hospital clinician or use NHS111. Further information on accessing help and support can be found in the attached guidance.

The clinically extremely vulnerable will get priority access to vaccination against COVID-19 before the general population and in line with the priority ordering set by the Joint Committee on Vaccination and Immunisation (JCVI). You will be contacted again by the NHS with more information on when and how you will be invited to get the vaccine. The vaccine is likely to make an important contribution towards protecting you from COVID-19. We expect to have been able to offer the first dose of the vaccine to you by mid-February.

Your local NHS will ensure that you can receive the vaccine as safely as possible, as well as any care and support needed. Even if you have had both doses of the vaccine, you should continue to follow this shielding advice until further notice as we continue to assess the impact of vaccination among all groups. The people you live with should continue to follow the public health rules and guidance as long as they are in place, including if you have received the vaccine and if they have received the vaccine.

The Government is extending the offer of a free 4-month supply of vitamin D supplements for all adults who are clinically extremely vulnerable to support general health. If you have not already applied you can register at www.nhs.uk/get-vitamin-d – Further guidance on how to safely take vitamin D supplements will be provided during the opt in process.

We will continue to update you as the situation changes and will issue further advice to you before this guidance comes to an end on 21 February. Once again, we thank you for your efforts to keep yourself and others safe.

Yours sincerely,
MATT HANCOCK ROBERT JENRICK
Secretary of State for Health and Social Care Secretary of State for Housing, Communities and Local Government

Part 2 – Guidance for clinically extremely vulnerable people

This guidance is for clinically extremely vulnerable people in England. The full guidance can be found online at gov.uk/coronavirus. This is additional guidance specifically for clinically extremely vulnerable people, to help you protect yourself from the virus by following these shielding measures. This guidance applies to clinically extremely vulnerable individuals only. Others living in a household with someone who is clinically extremely vulnerable are not advised to follow this guidance.

Socialising
The new national lockdown guidance, which applies to everyone, means that you must not leave or be outside of your home and garden, except for limited purposes which are set out in that guidance. We are advising clinically extremely vulnerable people to stay at home as much as possible. You can still go outside for exercise or to attend health appointments, but try to keep all contact with others outside of your household to a minimum, and avoid busy areas.

You can still meet with your support bubble, but you cannot meet others you do not live with unless they are part of your support bubble. Outdoors, you can meet one person from another household for exercise. This is part of the wider national regulations that apply to everyone. 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.

Work
You are strongly advised to work from home because the risk of exposure to the virus in your area may be currently be 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 need support to work at home you can apply for Access to Work. Access to Work will provide support for the disability-related extra costs of working that are beyond standard reasonable adjustments an employer must provide.

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, in line with the wider rules set out in the national lockdown guidance.

Education settings
As our knowledge of COVID-19 has grown, we now know that very few children and young people are at highest risk of severe illness due to the virus. Doctors have therefore been reviewing all children and young people who were initially identified as clinically extremely vulnerable to confirm whether they are still thought to be at highest risk. If you have already discussed this with your child’s doctors and they have confirmed your child is still considered clinically extremely vulnerable, your child should follow this shielding advice.

Under the current national lockdown, children will learn remotely until February half term, except for vulnerable children and the children of critical workers who may still attend school. Clinically extremely vulnerable children and young people should not attend school or other educational settings, because the risk of exposure to the virus in the community is now very high. Your school or college will make appropriate arrangements for you to be able to continue your education at home.

Travel
You are advised to stay at home as much as possible and not to travel unless essential (For example, to attend health appointments).

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, local volunteers or NHS Volunteer Responders). You can register to request priority access to supermarket delivery slots, if you do not have someone you can rely on to go shopping for you. If you already have priority access to a supermarket delivery slot, 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 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 priority access to supermarket delivery slots, 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. 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 for 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.

Accessing 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. We urge you to continue using the NHS and other health providers for your existing health conditions and any new health concerns.  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 www.nhs.uk/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. If you do need to receive care in person, you can. Your local NHS services are well prepared and will put in measures to keep you safe. It is also really 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. 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.

Any carers or visitors who support you with your everyday needs can continue to visit. This also applies for those of a child or young person in your care. They should follow social distancing guidance where close or personal contact is not required. 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, and transport to and from health appointments.

Call 0808 196 3646 between 8am and 8pm to arrange support or visit NHS Volunteer Responders website.

Registering for additional support
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 priority access to a supermarket delivery slot (if you have already got priority access that will continue – you do not need to do anything further)
● 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.