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Government advice for clinically extremely vulnerable people in England

This guidance has been updated to support the clinically extremely vulnerable in protecting themselves from exposure to coronavirus (COVID-19). It replaces previous guidance on shielding. It ties into the new Local Covid Alert Levels framework, meaning those at the highest risk of serious illness from the virus will receive specific advice depending on where they live.

The guidance is set out in two parts:

  1. Updated advice on protecting the clinically extremely vulnerable, based on the local COVID alert level in your area. This advice is less restrictive than previous shielding advice.
  2. Updated shielding advice that is more targeted and will only apply in some of the worst affected areas and only for a limited period of time. You are only advised to follow shielding advice if you receive a new written shielding notification.

This new guidance aims to strike a better balance between providing practical steps to help keep you safe while reducing some of the potentially harmful impacts on mental and social wellbeing that were associated with previous strict shielding.

The Government will continue to maintain the Shielded Patient List. They will monitor the virus over the coming months and if it spreads too much, they may need to advise you to shield again. In the future, the Government will only reintroduce formal shielding advice in the very worst affected local areas and for a limited period of time. This will only apply to some, but not all, very high alert level areas and will be based on advice from the Chief Medical Officer. The Government will write to you separately to inform you if you are advised to shield.

 

Local COVID level alert: medium

Socialising inside and outside the home

  • when seeing friends and family you do not live with (or have formed a support bubble with) you must not meet in a group of more than 6, indoors or outdoors
  • take extra precautions by strictly maintaining social distancing, meeting outside if possible, and keeping the number of different people they meet low
  • you do not need to maintain social distancing with members of your own household.

Work and school

  • you should continue to work from home where possible. If you cannot work from home, you can still attend your workplace as your workplace should be COVID-secure. The general advice on work has further details about what to do if you have concerns
  • all pupils and students should continue to attend education settings at all local COVID alert levels unless they are one of the very small number of pupils or students under paediatric care and have been advised by their GP or clinician not to attend an education setting.

Travel

  • there are no restrictions on travel but you should limit journeys on public transport where possible.

Going to shops and pharmacies

  • consider shopping or visiting the pharmacy at quieter times of the day. You can further protect yourself by strictly observing good hand hygiene and maintaining social distancing as much as possible.

If you require additional care and support

  • at all times, you should continue to access the social care and medical services you need. Providers of these services are making every effort to ensure services remain open and as safe as possible
  • you should continue to access the NHS services that you need, and you should contact the NHS if you have an urgent or emergency care need.

 

Local COVID alert level: high

Socialising inside and outside the home

  • you must not meet with people indoors in any setting unless they are part of your household or support bubble. This includes private homes, and indoors in hospitality venues, such as pubs and restaurants
  • you may continue to see friends and family you do not live with outside, including in a garden or other outdoor space. If you do so, you must not meet in a group of more than 6. In England, this limit of 6 includes children of any age
  • try to keep the number of different people you meet with low. The fewer people you meet, the less likely you are to catch COVID-19
  • you are encouraged to continue to go outside with your household and/or support bubble because of the benefits of exercise. If you do choose to meet other households outside of your support bubble, this must be outside, must be in groups of less than 6 people and we advise you to keep the numbers low
  • you do not need to maintain social distancing within your household.

Work and school

  • you should continue to work from home where possible. If you cannot work from home, you can still attend your workplace as your workplace should be COVID-secure. The general advice on work has further details about what to do if you have concerns
  • all pupils and students should continue to attend education settings at all local COVID alert levels unless they are one of the very small number of pupils or students under paediatric care and have been advised by their GP or clinician not to attend an education setting.

Travel

  • avoid travel where possible except for going to work, school, or for essential shopping
  • if you need to travel, walk or cycle if you can. If this is not possible, travelling in a private car with your own household or bubble is generally lower risk than public transport because you are likely to come into contact with fewer people.

Going to shops and pharmacies

  • reduce the number of shopping trips you make. If you do go to the shops, consider doing so at quieter times of the day
  • consider using online delivery slots for food shopping or ask friends and family to help deliver shopping or collect medicines for you
  • if you need further assistance with food shopping, NHS Volunteer Responders may be able to help.

If you require additional care and support

  • you should continue to receive care at home, either from professional social care and medical professionals, or from friends and family within your support bubble
  • you should continue to access the NHS services that you need, and you should contact the NHS if you have an urgent or emergency care need.

 

Local COVID alert level: very high

Socialising inside and outside the home

  • only meet friends and family who are not in your household or support bubble in certain outdoor public spaces
  • continue to go outside for exercise, but to avoid busy areas to minimise the chance of coming into close contact with others. Otherwise, you should stay at home as much as possible
  • you may want to maintain social distance within your household if practical.

Work and school

  • where at all possible you are strongly advised to work from home, because the rate of transmission of the virus in your area is very high
  • if you cannot work from home, and are concerned about going into work, you may want to speak to your employer about taking on an alternative role or change your working patterns temporarily (for example, to avoid travelling in rush hour)
  • if there is no alternative, you can still go to work. Your employer is required to take steps to reduce the risk of exposure to COVID-19 in the workplace. Your employer should be able to explain to you the measures they have put in place to keep you safe at work
  • where some employers are not managing the risk of coronavirus, the Health and Safety Executive (HSE) and local authorities will take action which can range from the provision of specific advice, issuing enforcement notices, stopping certain work practices until they are made safe and, where businesses fail to comply with enforcement notices, this could lead to prosecution
  • if you have concerns about your health and safety at work you can raise them with your workplace union, the Health and Safety Executive or your local authority
  • all pupils and students should continue to attend education settings at all local COVID alert levels unless they are one of the very small number of pupils or students under paediatric care and have been advised by their GP or clinician not to attend an education setting.

Travel

  • you may continue to travel to venues or amenities which are open, as well as for work or to access education. However, everyone should aim to reduce the number of journeys they make
  • in general, we advise clinically extremely vulnerable people to stay at home as much as possible and avoid any travel into or out of a local COVID alert level: very high area.

Going to shops and pharmacies

  • you are advised to significantly reduce your shopping trips. Where possible, you should consider shopping online. If you do need to go to the shops, try to do so at quieter times and maintain strict social distancing
  • you are advised to ask people in your household or support bubble to collect food and medicines for you. If you need more help with accessing food or medicines, NHS Volunteer Responders are still available to assist you.

If you require additional care and support

  • you should continue to receive care at home, either from professional social care and medical professionals, or from friends and family within your support bubble
  • you should continue to access the NHS services that you need, and you should contact the NHS if you have an urgent or emergency care need
  • we recognise that a small number of individuals may require additional support to follow the guidance at local COVID alert level: very high. Please contact your local authority if you need assistance.

 

Shielding guidance

Shielding guidance is advice and is not compulsory. Everyone’s personal circumstances are different, and you may find it helpful to review the advice with your GP or clinical teams to make decisions that work for you.

 

Support for you

The food and medicine boxes which were provided by the National Shielding Service stopped on 1 August, with people advised they can visit shops and pharmacies.

However, other forms of support – such as priority supermarket delivery slots and the NHS Volunteers Scheme, amongst a range of local volunteer schemes – will continue.

If you are concerned about support available to you, you should contact your local authority.

 

See all our coronavirus advice and guidance

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