Protecting clinically extremely vulnerable groups (shielding patients)

 

People who are defined as clinically extremely vulnerable are at very high risk of severe illness from coronavirus. There are 2 ways you may be identified as clinically extremely vulnerable:

  1. You have one or more of conditions listed below, or
  2. Your clinician or GP has added you to the Shielded Patient List because, based on their clinical judgement, they deem to you be at higher risk of serious illness if you catch the virus.

If you have been idenitified as clinically vulnerable, you will recieve a letter from NHS England advising you to shield. 

If you do not fall into any of these categories, and have not been contacted to inform you that you are on the Shielded Patient List, follow the general staying alert and safe guidance for the rest of the population.

If you think there are good clinical reasons why you should be added to the Shielded Patient List, discuss your concerns with your GP or hospital clinician.

People with the following conditions are automatically deemed clinically extremely vulnerable:

  • solid organ transplant recipients
  • people with specific cancers:
  •  people with cancer who are undergoing active chemotherapy
  • people with lung cancer who are undergoing radical radiotherapy
  • people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
  • people having immunotherapy or other continuing antibody treatments for cancer
  • people having other targeted cancer treatments that can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
  • people who have had bone marrow or stem cell transplants in the last 6 months or who are still taking immunosuppression drugs
  • people with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD)
  • people with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell disease)
  • people on immunosuppression therapies sufficient to significantly increase risk of infection
  • problems with your spleen, for example splenectomy (having your spleen removed)
  • adults with Down’s syndrome
  • adults on dialysis or with chronic kidney disease (stage 5)
  • women who are pregnant with significant heart disease, congenital or acquired
  • other people who 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

Over this period, we are advising the clinically extremely vulnerable to work from home. If you cannot work from home, you are advised not to go to work and may be eligible for the Coronavirus Job Retention Scheme (CJRS), Statutory Sick Pay (SSP), Employment Support Allowance (ESA) or Universal Credit.

We are advising this group to stay at home as much as possible, except to go outdoors for exercise or to attend health appointments. You may wish to meet up with one other person from outside your household or support bubble, for example, to exercise in an outdoor public place. You should always try to do so as safely as possible by maintaining social distancing. Please follow the guidance set out in the shielding section of the CEV guidance.

 

Protecting people more at risk from coronavirus

If you are clinically vulnerable, you could be at higher risk of severe illness from coronavirus. Please note: This is different from those clinically extremely vulnerable - you are not advised to shield.

You:

  • should be maintain social distancing, being especially careful to follow the rules and minimise your contacts with others
  • should continue to wash your hands carefully and more frequently than usual and maintain thorough cleaning of frequently touched areas in your home and/or workspace

Clinically vulnerable people are those who are:

  • aged 70 or over (regardless of medical conditions)
  • under 70 with an underlying health condition listed below (that is, anyone instructed to get a flu jab each year on medical grounds):
    • chronic (long-term) mild to moderate respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis
    • chronic heart disease, such as heart failure
    • chronic kidney disease
    • chronic liver disease, such as hepatitis
    • chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS) or cerebral palsy
    • diabetes
    • problems with the spleen
    • a weakened immune system as the result of certain conditions or medicines they are taking (such as steroid tablets)
    • being seriously overweight (a body mass index (BMI) of 40 or above)
  • pregnant

 

Full information on Tier 4 can be found here 

Published: Dec 31, 2020

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