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Shielding of extremely vulnerable people

Learn more about shielding against coronavirus COVID-19 - what it is, who it affects and answers to some frequently asked questions. [UPDATED 09 July]

Over the weekend, the Government introduced their latest updates which included changes to the shielding measures introduced to help protect extremely vulnerable people from contracting coronavirus (COVID-19), due to the risk of them developing a severe illness if they do.

Who is classed as 'extremely vulnerable'?

If you fall within one of the following groups of people, you should have received a letter from your medical team.

People falling into this extremely vulnerable group

People who:

  • have had an organ transplant
  • are having chemotherapy or antibody treatment for cancer, including immunotherapy
  • are having an intense course of radiotherapy (radical radiotherapy) for lung cancer
  • are having targeted cancer treatments that can affect the immune system (such as protein kinase inhibitors or PARP inhibitors)
  • have blood or bone marrow cancer (such as leukaemia, lymphoma or myeloma)
  • have had a bone marrow or stem cell transplant in the past 6 months, or are still taking immunosuppressant medicine
  • have been told by a doctor they you have a severe lung condition (such as cystic fibrosis, severe asthma or severe COPD)
  • have a condition that means they have a very high risk of getting infections (such as SCID or sickle cell)
  • are taking medicine that makes them much more likely to get infections (such as high doses of steroids or immunosuppressant medicine)
  • have a serious heart condition and are pregnant

Other people 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.

If you think you fall into one of the categories of extremely vulnerable people listed above and you have not received a letter or been contacted by your GP, you should discuss your concerns with your GP or hospital clinician.

Don’t be afraid to get in touch with them, we know it hasn’t always been clear who should follow what guidelines, and it’s important that you feel confident in the best ways to keep yourself safe.

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What are the updates to shielding measures?

(Updated 09 July)

The aim of shielding is to protect high risk or ‘clinically extremely vulnerable’ people and take additional steps to prevent themselves coming into contact with coronavirus (COVID-19).

The government have announced more updates to the shielding measures In England (click here for Scottish shielding measures). The latest updates on 6th July means that:

  • You no longer need to socially distance from people you live with.
  • You can meet in a group of up to six people outdoors, including people from other households, but stick to social distancing measures and stay two metres away from people from other households.
  • You may also form a ‘support bubble’ with one other household, but one of the households in the ‘support bubble’ should be a single adult household (either an adult living alone or with children under 18 only). You can all spend time together outside and inside each other’s homes, including overnight, without needing to socially distance.
  • The government support offer has been extended: you can still get a food box, care and/or medicine delivery until 31 July if you want it, and have registered online by 17 July. If you have been recently advised to shield there’ is more information below about what support is available.
  • The latest evidence shows that the risk of serious illness for most children and young people is low. All high risk children and young people should continue to shield until 31 July. A clinical discussion with your paediatric specialist or GP will be needed before any child or young person is removed from the shielded patient list. Health services will be in touch with children and their families over the summer, ahead of the new school term, to discuss what the new evidence means for them personally in the longer term. Families, carers and young people do not need to make immediate contact.
  • You should continue to strictly avoid contact with anyone who is displaying symptoms of COVID-19 (a new continuous cough, a high temperature, or a loss of, or change in, your sense of taste or smell).

A full list of updates are included on the Government website

Key areas include:

  • If you’re spending time outdoors, continue to wash your hands regularly with soap and water or hand sanitiser, and be careful to make sure you’re minimising contact with others outside of your household or support bubble.
  • You’re still advised not to work outside your home until 31 July.
  • If possible, you should have medical appointments over the phone, however you should continue to access essential services that you need and contact the NHS if you need urgent care. Talk to your medical team if you have an appointment before 31 July to decide whether this can happen over the phone, or whether you should be attending in person.

They have also announced that from 1 August, shielding will be paused and from this date they will be advising that people follow strict social distancing measures instead. This means that you can go out to more places and see more people, but you should continue to make sure you minimise contact with others outside your household or support bubble. 

They’ve outlined this in more detail, explaining what you can do in practise:

  • You can go to work, if you can't work from home, as long as the business is COVID-secure
  • Children who are clinically extremely vulnerable can return to their education settings if they are eligible, in line with their peers. Where possible children should practise frequent hand washing and social distancing.
  • You can go outside to buy food, to places of worship and for exercise but you should maintain strict social distancing.
  • You should remain cautious as you're still at risk of severe illness if you catch coronavirus, so the advice is to stay at home where possible and, if you do go out, follow strict social distancing.

The government will share more information and advice about these changes in the coming weeks, And we'll update this page to reflect this emerging guidance.

Remember, if you're worried about these changes, and you're able to stay at home safely, then you should continue to do so wherever possible. The official guidance is still to stay home as much as possible.

If, however, you feel it would be good for you to go outside for a short period of time, for example for your mental or physical health, then that is now allowed under these guidelines, but make sure you're taking as many steps as possible to keep yourself safe. There's some more information below about keeping safe when you go outside.

Shielding updates for Scotland

The above information is for England only, and the Scottish Government have shared the following updates.

If you’re shielding, we’re advising that from 10 July:

  • you can stop physically distancing from the people you live with
  • you can meet in groups of only 8 people, but don’t meet any more than two households each day, and only meet outdoors if you’re visiting another household’s outdoor space you can use their toilet
  • you can travel further than five miles from your house, as far as you want
  • you can book places to stay, such as self-catering accommodation, or travel to a second home, provided neither has shared facilities – with your household or extended household
  • you can form an extended household - that means, if you’re living alone, or living only with other people who are under 18 years of age, you can join another household. You and the members of that extended household do not need to physically distance from each other, and you can stay the night in each other’s houses if you choose. Households must partner exclusively – you can only form an extended household with one other household and them with you.
  • if there are children in your household who are under 12, they no longer need to physically distance from other children outside, as long as they themselves aren’t shielding.

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If I want to go outside, what can I do to keep safe?

(Updated 09 July)

As we mentioned above, people who are considered high risk are now allowed to spend time outdoors in groups of up to six people, but this can still seem daunting, and remember it’s a personal choice. If you do decide to spend time outdoors, you need to make sure you’re taking care to keep yourself safe. The government have provided some advice on what you can do to help with this:

  • Keep your distance from people outside your household. The government are still suggesting keeping two metres away from people as a precaution. You can also lower the risk by avoiding being face-to-face with someone, so you could try keeping side-to-side.
  • Wear a face covering. You must do this on public transport at all times, or when attending a hospital appointment, anyway.
  • Go outside when there are fewer people around, such as early in the morning.
  • Ideally, spend time in open areas.
  • Take particular care to minimise contact with others.
  • Do not share or exchange personal belongings (such as cups) with others.
  • Avoid going into enclosed spaces and other households, shops or buildings.
  • Spend as long as you feel comfortable outside.
  • If you’ would prefer not to spend time outside of your property, try spending time with the windows open to let in fresh air and get some natural sunlight, or get out into any private space (such as a garden or balcony).

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Can I get any help with food and medicines if I’m shielding?

Updated 09 July

We know that the idea of shielding can create a number of worries, including how you can make sure you have access to food and medicines. Wherever possible you should talk to your friends, family and neighbours about whether they can help support you with this. We know it can be hard to ask for help, but it is really important for you to reach out.

You can also use various online services to access resources as well. We’ve put together some information on services and resources in our blog on self-isolation.

The government has also been running a service to support those who are shielding by helping with:

  • food
  • shopping deliveries
  • any additional care you might need

If you’re registering for this support, you’ill need to do so by 17 July. For those who are already registered, this support will continue to be in place until 31 July, as the government hope to pause shielding measures from 1 August.

Register here

If you aren’t able to register online, you can also call 0800 028 8327

The government have been working with pharmacies to help them deliver medicines and prescriptions through a government-funded service. This delivery service will be stopping from 31 July. If you’re having medication delivered through the government- funded service – you’ll need to make other arrangements for this after this date.

Other arrangements can include:

  • asking someone who can pick up your prescription from the local pharmacy, (this is the best option, if possible)
  • contacting your pharmacy to ask them to help you find a volunteer (who will have been ID checked) to deliver it to you.
  • use an online NHS pharmacy who will offer free delivery of medicines
  • call 0808 196 3646 (8am to 8pm) to arrange for an NHS Volunteer Responder to pick up prescriptions for you.

You may also need to arrange for collection or delivery of hospital specialist medication that is prescribed to you by your hospital care team.

If you receive support from health and social care organisations, for example, if you have care provided for you through the local authority or health care system, this will continue as normal. Your health or social care provider will be asked to take additional precautions to make sure that you are protected.

You can also get support from the NHS Volunteer Responders to help with your shopping. The scheme has volunteers who can collect and deliver shopping, medication or other essential supplies to those who are shielding.

There are also check in and chat volunteers who provide telephone support to individuals who are at risk of loneliness.

This support will continue after the 31st July and you can call 0808 196 3646 to arrange this help. You can also apply online.

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What about hospital or GP appointments?

(Updated 09 July)

The advice from the government is that wherever possible, during this time, people should try to access medical help remotely, for example over the phone or internet.

However, you should continue to access the essential services that you need, and you should contact the NHS if you need urgent or emergency care.

If you have a scheduled hospital or other medical appointment before 31 July, talk to your GP or specialist to ensure you continue to receive the care you need in an appropriate setting, and to determine which of these appointments are absolutely essential.

It's possible that your hospital may need to cancel or postpone some clinics and appointments. You should contact your hospital or clinic to confirm appointments.

What should you do if you are living with someone who is extremely vulnerable?

Updated 09 July

We know that within our community, many people are living with their loved ones who would be classed as extremely vulnerable. Therefore we wanted to share the updates from the government for these people.

The good news is that from 6 July you’re no longer required to social distance from others in your household, as long as they are well.

Everyone within the household should continue to regularly wash their hands with soap and water for 20 seconds, avoid touching their face and clean frequently touched surfaces.

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What should I do if I’m caring for someone who is extremely vulnerable?

(Updated 09 July)

If you're caring for someone who is extremely vulnerable due to risk of severe illness from coronavirus (COVID-19), there are some simple steps that you can take to protect them and to reduce their risk at the current time.

  • Ensure you follow advice on good hygiene.
  • Wash your hands on arrival and often, using soap and water for at least 20 seconds or use hand sanitiser.
  • Avoid touching their face, particularly their eyes, nose and mouth.
  • Cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
  • Put used tissues in the bin immediately and wash your hands afterwards
  • Do not visit or provide care if you're unwell and make alternative arrangements for their care
  • Provide information on who they should call if they feel unwell, how to use NHS111 online coronavirus service and leave the number for NHS 111 prominently displayed
  • Information about different sources of support that could be used and further advice on creating a contingency plan is available from Carers UK
  • Look after your own well-being and physical health during this time.

It can help to talk to other people about how they are coping with these challenges and to connect with people digitally.

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About the author

I’m a member of the Children and Families Team at The Brain Tumour Charity and previously practised as a Speech and Language Therapist, working with children of all ages. I’m dedicated to supporting children, young people and families affected by a brain tumour by being there every step of the way to provide help, understanding and support, when it’s needed most.

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