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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 announced that they will be pausing shielding measures for those living in England.

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 06 August)

From 1 August the government announced that they would be pausing shielding measures. This is because the rate of transmission of coronavirus in the community has significantly fallen.

The changes include:

  • you do not need to follow previous shielding advice
  • you can go to work as long as the workplace is Covid-secure, but should carry on working from home wherever possible
  • clinically extremely vulnerable children should attend education settings in line with the wider guidance on reopening of schools and guidance for full opening: special schools and other specialist settings
  • you can go outside as much as you like but you should still try to keep your overall social interactions low
  • you can visit businesses, such as supermarkets, pubs and shops, while keeping 2 metres away from others wherever possible or 1 metre, plus other precautions
  • you should continue to wash your hands carefully and more frequently than usual and that you maintain thorough cleaning of frequently touched areas in your home and/or workspace
  • you will no longer receive free food parcels, medicine deliveries and basic care from the National Shielding Service

We know that this might feel quite daunting for a lot of people, so it might help to have a read through some of the practical tips on staying safe, see the guidance on how to stay safe outside your home.

You will still be able to get:

  • local volunteer support by contacting your local authority
  • prescriptions, essential items and food you buy delivered by NHS Volunteer Responders
  • priority slots for supermarket deliveries (if you previously registered for free food parcels)

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 06 August)

Now that the shielding advice has been paused, it means that people will be able to spend more time out and about. We know that this can seem a bit daunting, but 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 now do this by law in the following places:
    • Public transport
    • Indoor transport hubs (i.e. airports, train stations etc)
    • shops and supermarkets
    • indoor shopping centres
    • banks, building societies and post offices
  • Avoid crowded spaces, for example avoid travelling at peak times.
  • Do not share or exchange personal belongings (such as cups) with others.
  • Wash your clothes regularly
  • 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 06 August

From 1 August you will no longer be able to receive free food parcels, medicine deliveries and basic care from the National Shielding Service.

Other arrangements for medications 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 31 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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