Government plans to pause shielding from 1 August for vulnerable

30 July 2020

From 1 August, the government will pause shielding unless the transmission of COVID-19 in the community starts to rise significantly.

People who are identified as clinically extremely vulnerable may be at high risk of serious illness if they catch coronavirus (COVID-19). They have been advised to take additional action to prevent themselves from coming into contact with COVID-19 when transmission of coronavirus in the community is high.

If you’re clinically extremely vulnerable, you’re strongly advised to stay at home as much as possible and keep interactions outside to a minimum. This is called ‘shielding’, and the government is currently advising people to shield until 31 July and is regularly monitoring this position.

This guidance is government advice. It’s not the law. This guidance will be kept under regular review.

This advice is of a general nature and should be treated as a guide. This does not replace any local public health measures put in place to protect the local population. If there is an outbreak of COVID-19 within your area, please follow any guidance set out locally or any specific law which applies to the area you live in.

What will change from 1 August

From 1 August, the government will pause shielding unless the transmission of COVID-19 in the community starts to rise significantly.

This means:

  • the government will no longer be advising you to shield
  • the support from the National Shielding Service of free food parcels, medicine deliveries and care will stop
  • NHS Volunteer Responders will carry on delivering the food you buy, prescriptions and essential items to you if you need it
  • you will still be eligible for priority supermarket slots (if you have registered by 17 July)

You may still be at risk of severe illness if you catch coronavirus, so stay at home as much as you can and continue to take precautions when you do go out. You can do this by washing your hands regularly, avoiding touching your face and keeping 2 metres away from people outside of your household or bubble wherever possible.

From 1 August, you’ll be advised you could go out to more places and see more people, for example, the advice is:

  • you can go to work, as long as the workplace is COVID-secure – but carry on working from home if you can
  • children who are clinically extremely vulnerable can go back to school (when the rest of their class goes back)
  • you can go outside to buy food, to places of worship and for exercise – keeping 2 metres away wherever possible

Who this guidance is for

This guidance is for adults, and children and young people aged 0 to 18 who are clinically extremely vulnerable.

If you are clinically extremely vulnerable you should have received a letter advising you to shield, or have been told by your GP or hospital clinician directly to shield.

This includes clinically extremely vulnerable people living in long-term care facilities for the elderly or people with special needs.

Changes introduced from  6 July

The government has already made some changes to its guidance for people who are shielding because the transmission of COVID-19 in the community has gone down. The changes from 6 July were:

  • you no longer need to socially distance from people you live with
  • if you want to, you can meet in a group of up to 6 people outdoors, including people from other households
  • you may also form a ‘support bubble’ with one other household if you want to, 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 them, and have registered online by 17 July. If you have been recently advised to shield there is more information on the page below outlining on the support available to you below
  • the latest evidence indicates that the risk of serious illness for most children and young people is low. All 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

Definition of ‘clinically extremely vulnerable’

Expert doctors in England have identified specific medical conditions that, based on what we know about the virus so far, place some people at greatest risk of severe illness from COVID-19. Disease severity, medical history or treatment levels will also affect who is in this group.

Clinically extremely vulnerable people may include:

  • 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 which 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)
  • people on immunosuppression therapies sufficient to significantly increase risk of infection
  • 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

For more information about who has been classed as clinically extremely vulnerable, please visit the NHS Digital website.

If you’re still concerned, you should discuss your concerns with your GP or hospital clinician.

Clinically vulnerable groups

If you’re 70 or older, pregnant or usually need a flu jab for underlying medical conditions you might be in the ‘clinically vulnerable’ category. If so, follow the staying alert and safe (social distancing) guidance.

Clinically extremely vulnerable children and young people (0 to 18)

Specialists in paediatric medicine have reviewed the evidence on the level of risk posed to children and young people from COVID-19. The latest evidence indicates that the risk of serious illness for most children and young people is low.

Children and young people who are cared for just by their GP are very unlikely to need to continue to shield in the future. This includes children with conditions including asthma, diabetes, epilepsy and kidney disease. A small group of children who receive specialist care in hospitals may still be considered clinically extremely vulnerable following a consultation with their doctor. This includes those receiving cancer care or those at risk of severe infection due to an immunodeficiency.

All children and young people currently identified as Clinically Extremely Vulnerable, and advised to shield, should continue to do so until 31 July, when the government will pause shielding for everyone.

All decisions on whether children and young people should be removed from the shielded patient list (and therefore will not be advised to shield again in future if transmission starts to increase significantly) should be based on a consultation with your paediatric specialist or your GP who will be best placed to determine the most appropriate care. Your paediatric specialist or your GP will be in touch over the summer to have these discussions.

Returning to school

If your child is shielding, it is advised that they do not return to school or nursery before 31 July.

If you are a parent or carer who is shielding it is advised that your child only attends education or childcare settings if social distancing can be adhered to. If this is not possible, your child should be supported to learn or work at home until 31 July.

See guidance on supporting children and young people’s mental health and wellbeing.

Check this is the right guidance for you

You are not clinically extremely vulnerable if:

  • you do not have any of the conditions listed above
  • you have not been told by your GP or specialist that you are clinically extremely vulnerable or received a letter saying you are clinically extremely vulnerable

If you are not clinically extremely vulnerable you should follow the guidance on staying alert and safe (social distancing).

Spending time with family and friends

For adults or children who are shielding, what you need to do when spending time with other people depends on whether or not you live with them.

Spending time with people you live with

The rest of your household do not need to shield themselves, but they should do what they can to support you in shielding and to carefully follow guidance on staying alert and safe (social distancing).

You are no longer advised you need to observe social distancing with other members of your household as long as they are well. Everyone in your household should regularly follow the advice on hand washing and respiratory hygiene, including regularly washing hands with soap and water for at least 20 seconds, avoiding touching their face and cleaning thoroughly frequently-touched surfaces.