Coronavirus (COVID-19) Advice for the clinically extremely vulnerable

Guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19. Updated 1 April 2021

Easy read: Getting NHS help when you need it during the coronavirus outbreak (opens in a new window)

Translated content: Shielding vulnerable people guidance


In this section


Definition of clinically extremely vulnerable

Website: Definition of clinically extremely vulnerable groups from GOV.UK (opens in a new window)

People who are defined as clinically extremely vulnerable are at very high risk of severe illness from COVID-19. There are three ways you may be identified as clinically extremely vulnerable:

  1. you have one or more of the conditions listed on the Government website, Website: Definition of clinically extremely vulnerable groups from GOV.UK (opens in a new window)
  2. your hospital clinician or GP has added you to the Shielded patients list from NHS (opens in a new window) because, based on their clinical judgement, they deem you to be at higher risk of serious illness if you catch the virus
  3. You have been identified through the COVID-19 Population Risk Assessment (opens in a new window) as potentially being at high risk of serious illness if you catch the virus

If you do not fall into any of these categories and have not been informed that you are on the Shielded patients list, follow the national restrictions.


Who is this guidance is for?

This guidance is for everyone in England who has been identified as clinically extremely vulnerable from coronavirus (COVID-19). This includes those people who have been identified by the NHS as being clinically extremely vulnerable and those identified through the COVID-19 population risk assessment.

If you have been identified as being clinically extremely vulnerable, you will previously have received a letter from the NHS or from your GP telling you this. You may also have been advised to shield in the past.


What has changed

Shielding advice was paused on 1 April 2021. As restrictions have been eased following the move to Step 4 of the roadmap, we are advising clinically extremely vulnerable people, as a minimum, to follow the same guidance as everyone else. It is important that everyone adheres to this guidance.

However, as someone who is at a higher risk of becoming seriously ill if you were to catch COVID-19, you may wish to think particularly carefully about additional precautions you might wish to continue to take. Individuals may choose to limit the close contact they have with those they do not usually meet with in order to reduce the risk of catching or spreading COVID-19, particularly if they are clinically extremely vulnerable and if COVID-19 disease levels in the general community are high. It is important to respect and be considerate of those who may wish to take a more cautious approach as restrictions are lifted.

There are things that you can continue to do to lower your risk of infection and prevent the spread of COVID-19, and some examples are outlined in the sections below.


Vaccinaton

Everyone on the Shielded Patient List should already have been offered a COVID-19 vaccine. If you have not yet received your first dose, please contact your GP, book your vaccination appointment online (opens in a new window) or call 119. If you have received your first dose, you should still ensure you take up your second dose of the vaccine. Having 2 doses should further increase your level of protection. For some with immunosuppression it may only be with your second dose that a significant immune response is triggered.

No vaccine is 100% effective and therefore even if you have had both doses, there is still no absolute guarantee that you will not become ill from COVID-19. As such, you should continue to follow the guidance that is in place for everyone.


Socialising inside and outside the home

From 19 July, there are no longer any limits on the number of people or households that you can meet with. In addition, the requirement to socially distance from others has ended, other than in a few exceptions.

Social distancing rules (2 metres or 1 metre with additional mitigations) have been lifted. You should continue to consider the risks of close contact with others, particularly if you are clinically extremely vulnerable or not yet fully vaccinated. The risk of catching or passing on COVID-19 is generally higher:

  • in crowded spaces, where there are more people who might be infectious
  • in enclosed indoor spaces where there is limited fresh air
  • when COVID-19 disease levels are high in the general community

Because clinically extremely vulnerable people are at higher risk of severe illness from COVID-19, you may wish to think particularly carefully about taking precautions when meeting others you do not usually meet with in order to reduce the risk of catching or spreading COVID-19. For example, you could:

  • meet outside if possible – the particles containing the virus that causes COVID-19 are quickly blown away which makes it less likely that they will be breathed in by another person
  • make sure the space is well ventilated if you meet inside; open windows and doors or take other action to let in plenty of fresh air – please see the COVID-19: ventilation of indoor spaces guidance for more information (opens in a new window)
  • consider whether you and those you are meeting have been vaccinated – you might want to wait until 14 days after your second dose of a COVID-19 vaccine before being in close contact with others
  • wash your hands regularly and avoid touching your face
  • consider continuing to practice social distancing if that feels right for you and your friends
  • asking friends and family to take a lateral flow test before visiting you

You are encouraged to go outside for exercise and can do so freely now. 


Work

From 19 July, social distancing measures have ended in the workplace and it is no longer necessary for the government to instruct people to work from home.

However, employers still have a legal responsibility to protect their employees and others from risks to their health and safety. Your employer should be able to explain to you the measures they have in place to keep you safe at work. Some employers may request employees to undertake regular testing for COVID-19 to identify people who are asymptomatic.

The Health and Safety Executive (HSE) has published guidance on protecting vulnerable workers (opens in a new window), including advice for employers and employees on how to talk about reducing risks in the workplace (opens in a new window).

If you need support to work at home or in the workplace you can apply for Access to Work (opens in a new window). Access to Work may provide support for the disability-related extra costs of working that are beyond standard reasonable adjustments an employer must provide. Access to Work will prioritise applications from disabled people who are in the clinically extremely vulnerable group.

If you have access to occupational health and employee assistance programmes in the workplace, these services can also provide you with a range of health support and advice for your physical and mental health needs.

The Coronavirus Job Retention Scheme (furlough) (opens in a new window) is available until 30 September. You may be eligible throughout this period, even when shielding is paused, providing your employer agrees. The Self-Employment Income Support Scheme (SEISS) (opens in a new window) is also available until 30 September.

You may be eligible for Statutory Sick Pay (SSP) or Employment and Support Allowance (ESA) if you are sick or incapable of work, either due to coronavirus or other health reasons, subject to meeting the eligibility conditions.

If you have concerns about your health and safety at work then you can raise them with your workplace union, HSE or your local authority. Where employers are not managing the risk of COVID-19, 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.
The existing employment rights framework provides protections against discrimination, unfair dismissal and detriment. Specific guidance has been published for employers and workers on work absences due to coronavirus (COVID-19) (opens in a new window).

Citizens Advice (opens in a new window) also has information about your rights at work and how to solve problems in the workplace. If you have concerns you can also get advice on your specific situation and your employment rights by visiting the Acas website (opens in a new window) or calling the Acas helpline on 0300 123 1100.


School, college and other educational settings

It is important that children attend school for their education, wellbeing, mental health and long-term development. Clinically extremely vulnerable pupils and students should have returned to their school or other educational setting. This includes early years provision, wraparound childcare and applicable out-of-school settings.

Where parents are concerned about their child’s attendance, they should speak to their child’s educational setting about their concerns and discuss the measures that have been put in place to reduce the risk. They should also discuss other measures that can be put in place to ensure their children can regularly attend.

The use of rapid lateral flow tests helps us to identify individuals with COVID-19 who do not have symptoms, which make up around a third of all cases. Finding asymptomatic cases, along with other infection prevention and control measures can help us manage the spread of the virus.

To safeguard the health of the teaching workforce and keep as many staff, pupils and students in school and college as possible, we have made rapid lateral flow tests available (opens in a new window) to schools and colleges. Lateral flow tests can also be accessed directly for households of primary and secondary school pupils and for households of primary and secondary school staff. This testing will also help keep safe those in the community who are clinically extremely vulnerable and their families.

All early years providers, schools and colleges are continuing to put in place measures (opens in a new window) to help minimise the risk of spreading COVID-19. These include handwashing, use of face coverings in specific situations, enhancing cleaning, ventilation and managing suspected and confirmed cases.


Travel

Whilst the legal requirement to wear a face covering has been lifted from 19 July, the government expects and recommends that people continue to wear face coverings in crowded areas, such as public transport.

Wearing a face covering, especially when there is close contact between people in enclosed and crowded spaces will still help to reduce the risk of spreading COVID-19. It may also help those who are clinically extremely vulnerable feel more relaxed. It is important that face coverings fit securely around the face and safely cover the mouth and the nose.


Going to shops and pharmacies

Clinically extremely vulnerable people are now advised to follow the guidance that applies to the rest of the population. You may still wish to consider going to the shops and pharmacy at quieter times of the day.

Priority access to supermarket delivery slots using the Shielding Support website ended on 21 June. After 21 June, you can continue to book delivery slots in the usual manner from a supermarket.


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.

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 from the NHS (opens in a new window), or download the NHS App (opens in a new window). If you have an urgent medical need, call NHS 111 or, for a medical emergency, dial 999.

It is also important to look after your mental health. Go to the Every Mind Matters (opens in a new window) website for advice and practical steps that you can take to support your wellbeing and manage your mental health during this pandemic and beyond. The Let’s Talk Loneliness (opens in a new window) website also has a variety of tips, advice and further resources that you may find helpful.

If you or someone you care for experiences a mental health crisis, we urge you to make contact with a local health professional (opens in a new window) immediately. NHS Mental Health Trusts have established 24/7 telephone lines to support people of all ages to get the help they need, when they need it.

Any carers or visitors who support you with your everyday needs can continue to visit. They should continue to follow social distancing guidance from GOV.UK (opens in a new window) where close or personal contact is not required.

You can also access additional support from your energy supplier. Energy suppliers are required by the regulator, Ofgem, to hold a register of customers in a vulnerable circumstance, called a Priority Service Register. If you are clinically extremely vulnerable you can be added to this register. For information about how to be added to the register and the additional services your supplier can provide you, please visit Ofgem’s website (opens in a new window) website.

Telecom providers are also required by their regulator, Ofcom, to support their vulnerable customers. For information about the additional services your supplier can provide you as a vulnerable customer, please visit Ofcom’s website (opens in a new window).

Worcestershire County Council’s Here2Help service is still available to help support those who need it. Volunteers can collect and deliver shopping, medication and other essential supplies and we can also make referrals to other services if you need support. You can contact us by visiting Here2Help or by calling the a dedicated number on 01905 768053 and pressing option 3. The Here2Help opening hours are Monday to Thursday 9.00am to 5.00pm and Friday 9.00am to 4.30pm.