Advice for the Shielded
If you need support because you are vulnerable please ring 01204 337221.
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Shielding advice has been paused nationally from 31 March.
• From 1 April, Clinically Extremely Vulnerable (CEV) individuals are no longer advised to shield but must continue to follow the rules in place for everyone under the current national restrictions.
• The government has published ‘COVID-19 Response - Spring 2021’, which sets out the roadmap out of the current lockdown in England. This explains how restrictions will be eased over time.
• In addition to these rules that everyone must follow, we are also advising clinically extremely vulnerable people to continue to take extra precautions to protect themselves.
Why is shielding being paused?
• The decision to pause shielding has been taken based upon the latest scientific data and on the recommendation of the Chief Medical Officer.
• Since the national restrictions and shielding measures were introduced in January, cases of COVID-19 have fallen considerably across all parts of the country, Prevalence rates are now low enough that we can relax shielding advice.
• In addition, the majority of CEV people have now received their first dose of the vaccine. Whilst no vaccine can be 100% effective, this means CEV people are in general better protected against the virus.
Will the government be writing to clinically extremely vulnerable people?
• Yes, the government is writing to everyone on the Shielded Patient List in England advising them of these changes. Emails are also being sent where CEV individuals have registered their email address with their GP. The letters will be available online here and the main guidance page will be updated from 1 April
• Accessible versions of the letter will be produced as soon as possible and made available on GOV.UK.
Will clinically extremely vulnerable people need to shield again in the future? How will those decisions be taken?
• In the future, the government will only reintroduce formal shielding advice in the very worst affected areas and for a limited period of time. This will be based on a recommendation from the Chief Medical Officer.
• The government will write to you separately to inform you if you are advised to shield. You are not advised to follow formal shielding advice again unless you receive a new shielding letter advising you to do so.
Should GPs and clinicians continue to add and remove patients from the Shielded Patient List as required?
• Yes. The Shielded Patient List will continue to be maintained and GPs and clinicians should add or remove individuals as appropriate.
What is the guidance for clinically extremely vulnerable people post 31 March?
• Clinically extremely vulnerable people are no longer advised to shield from 1 April 2021.
• They should still work from home if they can, but if that is not possible, they can return to the workplace.
• Clinically extremely vulnerable people are advised that if they do go out to the shops or pharmacy, they consider going at quieter times of the day.
• Children on the Shielded Patient List are advised they should return to school or college.
• People on the Shielded Patient List should continue to take extra precautions set out in the guidance. This is set out in the letter we are issuing to people on the SPL, and from 1 April will also be available here: https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19
If clinically extremely vulnerable people have received their vaccine, do they still need to follow the guidance after 31 March?
• Yes. Even if an individual has had both doses of a vaccine, there is still no guarantee that they will not become ill from COVID-19 if they catch the virus. Therefore, they should continue to follow the extra precautions set out by the government, to help reduce their likelihood of infection.
• The guidance to clinically extremely vulnerable people is only advisory. It is not mandatory that they follow this advice, although they should be aware that not doing so may increase their risk of catching COVID-19.
• Everyone must continue to follow the regulations in place at each stage of the roadmap.
Will Clinically extremely vulnerable people households be prioritised for the vaccine? Why not?
• Clinically extremely vulnerable households are not prioritised for a vaccine in phase.
• Many individuals who are clinically extremely vulnerable will have some degree of immunosuppression or be immunocompromised and may not respond as well to the vaccine. Therefore, those who are clinically extremely vulnerable should continue to follow government advice on reducing their risk of infection. Consideration has been given to vaccination of household contacts of immunosuppressed individuals. However, at this time there is no data on the size of the effect of COVID-19 vaccines on transmission. Evidence is expected to accrue during the course of the vaccine programme, and until that time the committee is not in a position to advise vaccination solely on the basis of indirect protection.
• Adult Carers: Those who are eligible for a carer’s allowance, or those who are the sole or primary carer of an elderly or disabled person who is at increased risk of COVID-19 mortality and therefore clinically vulnerable will be prioritised for a vaccine in cohort 6, alongside individuals with certain underlying health conditions.
What about those individuals recently added to the Shielded Patient List through the QCovid model?
• Individuals recently added to the Shielded Patient List as result of the population risk assessment should follow the same advice as provided to the clinically extremely vulnerable.
• Shielding advice is being paused from 31 March, they will therefore no longer be advised to shielding but must continue to follow the rules in place for everyone under the current national restrictions.
• Individuals are advised to continue to take extra precautions to protect themselves, these include working from home as much as possible and shopping at quieter times.
Will Clinically extremely vulnerable people keep priority access to a supermarket delivery slots after the 31 March?
• All supermarkets have committed to continuing priority access to supermarket delivery slots until 21 June (step 4 of the roadmap) for those clinically extremely vulnerable individuals who have already signed up for support. Some supermarkets may choose to extend their offer beyond 21 June but will be in touch to explain the terms of any offer. Even where supermarkets end priority access on 21 June, individuals can continue to book deliveries from a supermarket.
Can clinically extremely vulnerable people now safely leave their homes to go shopping for food or medicines?
• Whilst they are not advised to avoid going to the shops, individuals may wish to continue using online delivery for food and essential shopping, or to rely on family and friends. If they do go out to the shops or pharmacy, you should consider going at quieter times of the day. Individuals must wear face coverings in all shops unless they are exempt.
Will the medicine delivery service end after 31 March?
• After this date, if it is not possible for someone to attend their pharmacy, and friends and family are not able to collect medicine for them, then the NHS Volunteer Responders will continue to offer medicines deliveries. If someone is vulnerable or at risk and needs help with shopping, medication or other essential supplies, they should call 0808 196 3646 (8 am to 8pm).
Employment and welfare support
Can clinically extremely vulnerable people go back to work if they cannot work from home?
• Everyone is currently advised to work from home where possible. If individuals cannot work from home, they can still go to work.
• Employers are required to take steps to reduce the risk of exposure to COVID-19 in the workplace and should be able to explain to the measures they have put in place to keep people safe at work. We encourage clinically extremely vulnerable employees and their employers to have conversations as early as possible about their return to work,
• Where employers are not managing the risk of COVID-19, 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.
How should employers be supporting Clinically extremely vulnerable people to come back to work?
• Employers are required to take steps to reduce the risk of exposure to COVID-19 in the workplace and should be able to explain the measures they have put in place to keep people safe at work.
• Workplace specific safer working guides set out how different workplaces should be made COVID-secure, including how to maintain social distancing and a system of risk management in the workplace: https://www.gov.uk/guidance/working-safely-during-coronavirus-covid-19.
• The Health and Safety Executive also provides information to employers on making workplaces COVID-secure and on protecting vulnerable workers: https://www.hse.gov.uk/coronavirus/working-safely/protect-people.htm
• The covernment is asking employers to work with us to ease the transition back to a more normal way of life for their clinically extremely vulnerable employees. It is important that this group continue to take careful precautions, and employers should do all they can to enable them to work from home where this is possible, including moving them to another role if required.
• Where working from home is not possible, those who have been shielding should be provided with the safest onsite roles that enable them to maintain social distancing from others.
• The Coronavirus Job Retention Scheme (furlough) has been extended until 30 September and the clinically extremely vulnerable remain eligible for this even whilst shielding guidance is not in place.
• We encourage clinically extremely vulnerable employees and their employers to have conversations as early as possible about their return to work, and on how best to support them to manage their risk and work safely. The Health and Safety Executive has published resources to support employers in having conversations about preventing the spread of
coronavirus in the workplace with their employees: https://www.hse.gov.uk/coronavirus/working-safely/talking-to-your-workers/index.htm. This includes specific information and guidance for employers on stress, wellbeing and providing mental health support.
Do the clinically extremely vulnerable have to go back to work even if they don’t feel safe to? What are their rights?
• Employers are required to take steps to reduce the risk of exposure to COVID-19 in the workplace and should be able to explain the measures they have put in place to keep people safe at work.
• If CEVs have concerns about their health and safety at work they can raise them with their workplace union, the Health and Safety Executive (HSE) https://web.archive.org/web/20201018050420/https:/www.hse.gov.uk/contact/concerns.htm or their local council.
• Where some employers are not managing the risk of coronavirus, 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 also provides protections against discrimination, unfair dismissal and detriment. Further information for employers and workers on work absences due to coronavirus (COVID-19) can be found here: https://www.gov.uk/guidance/if-you-need-to-self-isolate-or-cannot-attend-work-due-to-coronavirus.
• The Citizens Advice Bureau also has information about workers’ rights and how to solve problems in the workplace: https://www.citizensadvice.org.uk/work/.
• Employees can get advice on their specific situation and their employment rights by visiting the Acas website https://www.acas.org.uk/contact or calling the Acas helpline on 0300 123 1100.
28. What about if CEVs are concerned about their risk during their journey to work (e.g. they have to use public transport)?
• The Department for Transport (DfT) has worked with the Health & Safety Executive (HSE), Public Health England (PHE) and the Department for Business Enterprise and Industrial Strategy (BEIS) to develop Safer Guidance for Transport Operators in order to protect transport workers and passengers: https://www.gov.uk/government/publications/coronavirus-covid-19-safer-transport-guidance-for-operators/coronavirus-covid-19-safer-transport-guidance-for-operators#social-contact
• Operators are also ensuring they implement the Safe Workplace guidance. These actions ensure that operators are keeping their workers and passengers safe.
• DfT has also consulted industry stakeholders and trade unions throughout the pandemic in order to ensure best practice approaches are followed and the transport sector operates safely.
• Since the start of the pandemic we have encouraged the public to follow mitigations, introducing requirements for mandatory face coverings on all public transport
• DfT has also provided emergency support to public transport operators to ensure the continuity of essential services during pandemic. This has included express provision
for measures to protect transport workers and the public including PPE, passenger spacing, screens, barriers, additional cleaning services.
What financial/employment support is available for the clinacally extremely vulnerable at this time?
• The Coronavirus Job Retention Scheme (furlough) has been extended until 30 September. Clinically extremely vulnerable employees can be furloughed throughout this period, provided their employer agrees. https://www.gov.uk/government/collections/coronavirus-job-retention-scheme.
• For the self-employed clinically extremely vulnerable, the Self-Employment Income Support Scheme (SEISS) has also been extended until September: https://www.gov.uk/government/publications/self-employment-income-support-scheme-grant-extension
• The clinically extremely vulnerable who need support to work at home or in the workplace may be able to apply for Access to Work, which provides support for the disability-related extra costs of working that are beyond standard reasonable adjustments an employer must provide: https://www.gov.uk/access-to-work
• There is a wide range of support available for people who are affected by coronavirus or its effect on the economy, including Universal Credit (UC), which is available to people who are in and out of work, including those who are on furlough. The £20 per week increase to UC will remain in place until September. More information about employment and benefits support can be found here: https://www.understandinguniversalcredit.gov.uk/employment-and-benefits-support/
• The Health and Safety Executive has published resources to support employers and employees in having conversations about preventing the spread of coronavirus in the workplace: https://www.hse.gov.uk/coronavirus/working-safely/talking-to-your-workers/index.htm
• The Citizens Advice Bureau has information about workers’ rights and how to solve problems in the workplace: https://www.citizensadvice.org.uk/work/. Employees can also get advice on their specific situation and their employment rights by visiting the Acas website https://www.acas.org.uk/contact or calling the Acas helpline on 0300 123 1100.
Are clinically extremely vulnerable still eligible for SSP and ESA?
• Where clinically extremely vulnerable individuals are no longer required to shield, and they are unable to work from home but can work on site, they should do so. Shielding guidance must be in place in order for employees to be eligible for SSP on the basis of shielding.
• Employees will be remain eligible for SSP if they are unable to work and are sick, or required to self-isolate, provided they meet all eligibility conditions.
• People who are unable to work due to their health condition or disability will remain eligible for ESA provided they meet the eligibility conditions (ESA as per business as normal).
Will clinically extremely vulnerable be told to shield again in future and what support will be available for them to protect their job/income?
• Guidance around shielding will be continually reviewed and informed by the latest scientific evidence and advice. We will continue to assess the support in place should advice to shield be reinstated.
• The government expects employers to do the right thing, including in this scenario.
• Where home working is not possible, employers will be able to access the Coronavirus Job Retention Scheme (furlough) until 30th September 2021.
• For those who have not been furloughed, clinically extremely vulnerable employees who are notified to shield again should again be eligible for Statutory Sick Pay (SSP) or Employment and Support Allowance (ESA) for the period they are advised to shield themselves, if all other SSP or ESA eligibility conditions are met.
Can clinically extremely vulnerable children and young adults go back to school/college/university now that shielding has been paused?
• From 1 April clinically extremely vulnerable pupils and students should return to their school or other educational setting now that shielding has been paused.
• Higher education students who are on practical or practice-based courses began to attend from 8 March, as well as those who were on specific courses who returned in January.
Do children of clinically extremely vulnerable adults or clinically extremely vulnerable adults themselves need to attend school?
• It is important that children attend school for their education, well-being, mental health and long-term development. School attendance is mandatory and the advice for children who live with someone who is clinically extremely vulnerable or clinically vulnerable is clear that they should attend school. This advice is informed by the latest medical evidence and has been agreed with the Deputy Chief Medical Officer.
• We have asked schools to continue to implement a range of protective measures to ensure they are as safe as possible. Regular testing of children in schools will further reduce the risk of transmission. Most clinically extremely vulnerable adults will also now have had at least one dose of the vaccine.
• Where parents are anxious about their child's attendance, they should speak to their child's school about their concerns and discuss the protective 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 that their children can regularly attend school.
• In schools, the usual attendance rules continue to apply, including a headteacher's ability to grant a leave of absence in exceptional circumstances.
• Higher education and FE students have been able to attend education settings from 8 March, as have those who were on specific courses who returned in January.
Is it safe for clinically extremely vulnerable pupils and students to attend education settings?
• As our knowledge of COVID-19 has grown, we now know that very few children and young people are at highest risk of severe illness due to the virus.
• Education settings have implemented a range of protective measures recommended by the Public Health England (PHE) endorsed in guidance published by Department for Education (DfE) which, when followed, creates an inherently safer environment for pupils, staff and families.
• Where parents are anxious about their child's attendance, they should speak to their child's school or college about their concerns and discuss the protective 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 that their children can regularly attend school or college.
What measures will be put in place by schools and colleges to allow them to return?
• Rapid testing using Lateral Flow Devices (LFD)s will support the return to face-to-face education by helping to identify people who are infectious but do not have any coronavirus (COVID-19) symptoms. Lateral flow tests can also be picked up directly for households, childcare and support bubbles of primary and secondary school pupils and for households, childcare and support bubbles of primary and secondary school staff.
• To support the return of face-to-face education rapid lateral flow devices are being made available to schools. In addition to testing, secondary schools and colleges are continuing to put in place a range of protective measures to help children minimise their risk of infection by and transmission of Covid-19. These include social distancing, handwashing, face coverings where needed, bubbles, enhanced cleaning and ventilation and managing confirmed cases. Implementing the system of controls outlined in DfE guidance, creates a safer environment for students and staff where the risk of transmission of infection is substantially reduced.
What help is available to support young people’s mental health and wellbeing?
• We have recently announced a £79 million boost to children and young people’s mental health support, including through Mental Health Support Teams.
• The government has invested £8m in training and support for educational staff, delivered through Local Authorities and is helping colleges to better support students’ mental health with the £5.4m College Collaboration Fund.
• The newly established Mental Health Action Group will continue to look at the support available across education settings to help staff, students, and pupils in their return to school, college and university. Dr Alex George, our newly appointed Youth Mental Health Ambassador, will be part of this Action Group, to advise government and raise the profile of mental health education and wellbeing in schools, colleges and universities.
• The £1bn Covid catch-up package will support educational settings to put the right pastoral support in place and fund activities focused on mental wellbeing, re-engagement and behaviour.
• In addition, the government has provided over £10m funding to mental health charities to help them adapt, expand and reach those who are most vulnerable. For those who need support outside of school and college, all NHS Mental Health Trusts have provided 24/7 telephone lines to support people of all ages.
What are you doing to help children and young people catch up when they return to the classroom?
• The government has invested £1.7 billion to support education recovery.
• This includes a £1 billion catch-up package announced in June 2020, encompassing a National Tutoring Programme and a Catch-up Premium for the 2020/21 academic year. A further £700 million was announced in February 2021, to fund summer schools, an expansion of our tutoring programmes and a Recovery Premium for the 2021/22 academic year. Additionally, the Prime Minister and Secretary of State for Education have appointed Sir Kevan Collins as the Education Recovery Commissioner to advise ministers, on the approach for education recovery and the development of a long-term plan to help pupils make up their learning over the course of this parliament.
• The Education Recovery Commissioner will engage with parents, pupils/students, and teachers in the development of this broader approach which will examine a range of options to help education settings to use evidence-based interventions to support their pupils/ students to make up lost learning. We will share further details in due course.
Access to health, care, and mental health support
What if the clinically extremely vulnerable require additional care and support?
• It is important that all individuals continue to receive the care and support they need to help 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.
• Individuals should continue to seek support from the NHS for existing health conditions. A range of NHS services can be accessed from home, including ordering repeat prescriptions, or contacting health professional through an online consultation. To find out more visit www.nhs.uk/health-at-home, or download the NHS App.
What mental health support is available to help me manage this transition?
• The mental health and wellbeing of everyone is absolutely critical in these unprecedented times.
• DHSC published their Wellbeing and Mental Health Support Plan for COVID-19 in November 2020, which sets out the support being made available for people in the context of a second wave and the winter months.
• Community mental health services will ensure proactive outreach and review for the most vulnerable. In line with the guidance on supporting mental health providers to care for patients who have been advised to shield, providers should identify people deemed to be vulnerable who are in receipt of or have received care from their service, proactively contact these people, and optimise their care through reviewing and amending care plans as necessary.
• All mental health providers, including providers of psychological therapies, have been issued with guidance to encourage them to deliver care remotely so that vulnerable groups can receive care safely.
• Talking therapies will continue to be made available remotely so people can access help safely from home, whilst the NHS works to ensure that face to face support is available for those with the most serious mental health illnesses.
• Mental health trusts in England have been instructed to put in place 24/7 crisis lines for all ages so people can get urgent help whenever they need it. A national service finder for local urgent mental health telephone lines is available on the NHS.UK website.
What help is available for people who are struggling with their mortgage?
• Applications for the mortgage holiday close on 31 March 2021, and mortgage holidays can run until 31 July. Borrowers that have been impacted by coronavirus and have not yet had a mortgage payment holiday will be entitled to a six-month holiday, and those that have already started a mortgage payment holiday will be able to top up to six months without this being recorded on their credit file.
• The FCA has been clear that for borrowers who have taken six months’ holiday and continue to face ongoing financial difficulties, firms should continue to provide support through tailored forbearance options. This could include granting new mortgage payment holidays. Mortgage customers in this situation should speak to their lender to discuss their options.
• Any forbearance granted beyond six months of payment holidays will be reflected on the consumer’s credit file in the usual manner. As borrowers still requiring assistance after that point could be in serious financial distress, the FCA believe it is right that lenders are able to understand their financial position in order to lend responsibly.
• Further information on mortgages and the support available during the coronavirus outbreak is available from the Money Advice Service and UK Finance.
Will support for homeless and rough sleeping continue now that shielding is being paused?
• We have redoubled our efforts to ensure that people who sleep rough are kept as safe as possible and that we do everything we can to protect the NHS. This is backed by £10 million to protect rough sleepers and ensure their wider health needs are addressed.
• We have asked all local authorities to ensure that even more rough sleepers are safely accommodated, and that this opportunity is actively used to make certain that all rough sleepers are registered with a GP, where they are not already, and are factored into local area vaccination plans, in line with JCVI prioritisation for Covid vaccinations.
• We have taken huge steps working with local authorities and their partners to protect rough sleepers during the pandemic. This work has not stopped, and by the end of January, we had supported over 37,000 people with over 11,000 in emergency accommodation and over 26,000 already moved on into longer-term accommodation.
Can tenants be evicted from their home during this period?
• The stay on possession proceedings expired on 20 September 2020 and landlords are now able to progress their possession claims through the courts. However, measures to protect tenants remain in place.
• Longer notice periods and new court rules apply. Courts will carefully prioritise the most egregious cases, such as those involving anti-social behaviour and other crimes and landlords need to provide the courts and judges with information on how tenants have been affected by the pandemic.
• Landlords must provide 6-months' notice before starting possession proceedings in the courts for all but the most serious cases such as rent arrears of more than 6 months and anti-social behaviour. This requirement will remain in place up to 31 May.
• Legislation is in place to ensure bailiffs do not serve eviction notices or carry out evictions, except in the most serious circumstances and this will remain in place up to the end of 31 May. The only exceptions to this are illegal occupation, false statement, anti-social behaviour, perpetrators of domestic abuse in the social sector, where a property is unoccupied following death of a tenant and serious rent arrears of 6 months’ rent or more.
• Guidance to support landlords and tenants is available at COVID-19 and renting: guidance for landlords and tenants.
Can private rented sector tenants who are worried about transmission of Covid-19 refuse to let someone into their house for repairs and maintenance work?
• Tenants who are not self-isolating but who are concerned about the transmission of COVID-19 may be reluctant to allow landlords, or their contractors, to enter their homes to carry out work. These tenants may decide they wish to delay this work.
• In these cases, landlords should work with tenants to help them understand why the work is necessary, what the risks are of not carrying out the work and to try find a way to carry out work safely if possible. If tenants do delay work for these reasons, it is vital that they schedule these works as soon as they feel it is safe to do so.
• Tenants who are concerned about landlords or contractors entering their homes to carry out work should discuss this with their landlord and may also wish to contact their local authority, who are responsible for enforcing standards in privately rented homes.
• It’s important to remember that tenants still have a right to a decent, warm and safe place to live – and it is in the best interests of both tenants and landlords to ensure that properties are kept in good repair and free from hazards. Landlords should take account of government guidance on working safely in people’s homes when resuming repair and maintenance services in properties occupied by tenants.
What can people who live in shared or overcrowded accommodation do about Covid 19 transmission?
• Individuals should follow the guidance on how to stop the spread of coronavirus at all times and for those who are living in overcrowded or shared accommodation, or accommodation with shared facilities such as a block of flats, there is guidance available on additional steps that should be considered for reducing the risk of infection.
• Where a property is rented, we encourage residents and landlords (where there is one) to work together wherever feasible to support everyone to follow social distancing. As local authorities have powers to require landlords to remedy serious hazards, including overcrowding, we advise tenants of properties where serious overcrowding affects their ability to follow coronavirus guidance to contact their local authority. We also advise tenants to discuss their needs with their local authority.
What is the role for the voluntary and community sector ?
• The NHS Volunteer Responders Programme will continue providing support with food, prescriptions and essential items to those that need to self-isolate for any reason, including if they are vulnerable for any reason, have COVID-19 symptoms or have been in contact with someone who has. Individuals can call 0808 196 3646 and ask for help. More information is available here: https://volunteering.royalvoluntaryservice.org.uk/nhs-volunteer-responders-portal/isolating