Your questions answered and all the latest guidance explained.
Page last updated on 13 November 2020
We will continue to review the situation on a daily basis and will update this information as the advice continues to change.
The UK Government have announced England will move into national lockdown on Thursday 5 November. With the most recent announcements of alert levels for England, you can find out the alert level for your area. Please note, these restrictions will be replaced by national restrictions from 5 November. Everyone who's in the clinically vulnerable group should be especially careful to follow the rules and minimise contact with others. The Department of Health and Social Care has updated guidance for the clinically extremely vulnerable in line with the new national restrictions announced by the Prime Minister on 31 October 2020.
The guidance advises that the clinically extremely vulnerable should stay at home at all times, unless for exercise or medical appointments.
Furthermore, those who cannot work from home should not go to work, but people in the same household may enter their usual work place in line with the national restrictions. School children who previously self-isolated can still attend school, unless informed otherwise.
This guidance is for everyone in England who has been identified as clinically extremely vulnerable. If you are in this group, you will receive a letter from the NHS or from your GP providing you with further detail on the updated guidance and on how to access the support available. You may have been advised to shield in the past.
This guidance applies to clinically extremely vulnerable individuals only. Others living in a household with someone who is clinically extremely vulnerable are not advised to follow this guidance. They should instead continue to attend work and school in accordance with the general advice and regulations set out in the National Restrictions guidance from 5 November.
The UK Government had eased restrictions for vulnerable people. This meant that from 1 August in England, Scotland and Northern Ireland people could stop shielding; and in Wales, shielding was paused from 16 August.
1. How long is the additional guidance to clinically extremely vulnerable people in place for?
- The Government has introduced new National Restrictions guidance, which will come into effect on 5 November and will apply until Wednesday 2 December. The advice for the clinically extremely vulnerable will cover this same period. At the end of the period, we will look to return to a regional approach, and we will issue further guidance at the time.
2. Why are you not reintroducing full shielding as in March?
- The new National Restrictions guidance announced on 31 October will protect everyone, including those who are clinically extremely vulnerable (CEV).
- We are introducing additional advice and support for CEV people to help further protect them. Whilst this does not go as far as previous shielding guidance, it does contain similar protections and support.
- Previous shielding advice introduced in March helped protect those most at risk from COVID-19, but many people told us they found this advice very restrictive. We have therefore made measured relaxations to the advice, such as advising CEV people to continue to go outside for exercise.
- The full new guidance for CEV people is published here.
- Translations and accessible formats of this guidance will also be made available in the coming days.
3. How is this different to shielding in March?
- We know that during the first period of national shielding between March and July, many people found the advice very restrictive. The new guidance acknowledges this and provides practical steps to help keep you safe while reducing some of the potentially harmful impacts on mental and social wellbeing of previous shielding guidance.
- While we are still advising CEV people to stay at home as much as possible, you can go outside to take exercise or to attend essential health appointments.
- There is also no need for self-isolation within your household, although you are advised to social distance where possible and follow the guidance of ‘Hands. Face. Space’
4. Who will the new guidance apply to?
- The new guidance applies to individuals who have been deemed to be Clinically Extremely Vulnerable (CEV), meaning that they face the highest risk of serious illness if they contract COVID-19. If you are in this group, you may have received a letter from the NHS or from your GP telling you this, and you may have been advised to shield in the past. See the guidance on Definition of Clinically Extremely Vulnerable groups for more details.
- Down’s syndrome (adults only) and chronic kidney disease (stage 5) have recently been added as conditions that meet the criteria of extreme clinical vulnerability, and therefore the new guidance also applies to individuals with either condition.
5. Are these new rules compulsory?
- As before, the guidance for the clinically extremely vulnerable is advisory, although you are strongly advised to follow the advice in order to keep yourself safe.
6. Will you be writing to CEV people?
- Yes, we will write to everyone on the shielded patient list advising them of these changes. Guidance will also be available on the gov.uk website.
7. Can I still access NHS service / social care services?
- Yes. It is important that you continue to receive the care and support you need to help you stay safe and well.
- You should continue to seek support from the NHS for any health conditions.
- You can access a range of NHS services from home, including ordering repeat prescriptions or contacting your health professional through an online consultation. To find out more visit www.nhs.uk/health-at-home, or download the NHS App. If you have an urgent medical need, call NHS 111 or, for a medical emergency, dial 999.
- Any carers or visitors who support you with your everyday needs can continue to visit. They should follow social distancing guidance where close or personal contact is not required.
8. Does my whole household have to shield?
- No. Other members of your household are not required to shield and should follow the new National Restrictions guidance for the general population. That means they should continue to go to work and/or school.
- To further protect yourself from COVID-19, you should try to stay two metres away from other people within your household, especially if they display symptoms of the virus or have been advised to self-isolate. You should also follow the guidance of ‘Hands. Face. Space’.
9. Will I be able to go outside?
- Everyone is advised to stay at home as much as possible, but you are still encouraged to go outside for exercise or to attend health appointments.
- If you do go out you should keep all contact with others to a minimum and avoid busy areas. You should also follow the guidance of ‘Hands. Face. Space’.
10. Do children have to go to school?
- We know that children, even those with existing health conditions, have a very low risk of becoming very unwell from COVID-19. We also know how important it is for children to be able to continue their education. Speak to your child’s specialist doctor or GP if you have not already done so, to understand whether your child should still be classed as clinically extremely vulnerable.
- Those children whose doctors have confirmed they are still clinically extremely vulnerable are advised not to attend school whilst this advice is in place. Your child’s school will make appropriate arrangements for them to be able to continue their education at home.
- Children who live with someone who is clinically extremely vulnerable, but who are not clinically extremely vulnerable themselves, should still attend school.
11. Can I look after my grandchildren?
- You are advised to minimise all social interactions, including providing childcare, even if part of a childcare bubble.
12. Are you adding new groups to the shielded patient list?
- The shielded patient list is monitored regularly, and if scientific evidence shows that other groups face a very high risk of severe illness from COVID-19 then they would be added to the shielded patient list and informed of this.
- Based on the latest evidence, we are adding adults with Down’s syndrome and all those with chronic kidney disease (stage 5) to the shielded patient list. will receive a letter from the NHS informing them that they have been added to the Shielded Patient List. Their GP or clinician should also contact them.
13. Why is the Government announcing this now? Why is the advice for England different to the advice for other parts of the UK?
- The new guidance has been announced because coronavirus cases are rising rapidly across the country, and this advice is designed to further protect the most vulnerable. Each nation within the United Kingdom has a slightly different health system and this information only applies to those living in England. The new National Restrictions also only apply in England.
14. This is a huge sacrifice for individuals - how confident are you that this is effective in keeping the clinically extremely vulnerable safe?
- We understand how hard these measures can be for individuals to follow, but we are confident that this advice strikes the best balance between preventing exposure to the virus with the potential negative physical and mental health consequences of asking people to isolate themselves.
- This guidance will remain in place for the 4 weeks up to 2 December.
15. Is there different guidance if I live in a Tier 2 or Tier 3 area?
- No. This new guidance, as well as the new National Restrictions, will apply to the whole of England until 2 December.
16. Why didn’t you introduce these restrictions in Tier 3 areas before? Is this the new guidance for Tier 3 areas?
- When formal shielding guidance was introduced in March many people found it to be very restrictive. Since it was paused at the end of July, the Government has aimed to strike the best balance between preventing exposure to the virus with the potential negative physical and mental health consequences of asking people to isolate themselves. Unfortunately, COViD-19 cases are rapidly rising across the whole of the UK and it is necessary to now take further measures.
- The new National Restrictions and additional advice for CEV individuals is not the new guidance for Tier 3 areas. It is new guidance that covers the whole of England from 5 November until 2 December. At the end of the period, we will look to return to a regional approach, and we will issue further guidance at the time.
17. Why are people being asked to follow this guidance even in areas previously categorised as ‘medium’?
- Cases of COVID-19 are rising across the country, and even in areas where the level of incidence remains low, current scientific projections predict that hospital capacity would run out in the coming weeks unless action is taken. This is why the new National Restrictions measures have been implemented and why updated advice has been provided to further protect the most vulnerable.
18. Can I exercise outside? If so, how often and for how long? Can I drive to exercise?
- Yes, you are encouraged to continue to exercise outside because of the health benefits that this brings. You can go out for as long and as often as you wish, although you are generally advised to stay at home as much as possible.
- Everyone should avoid travelling in or out of their local area, and should look to reduce the number of journeys they make. Additional advice to CEV people is that they should avoid all non-essential travel by private or public transport, but can travel a short distance to exercise if this is necessary
19. What support will be offered to CEVs?
- If you are Clinically Extremely Vulnerable and you need support to access food, or you have other support needs to help you to stay at home as much as possible, you will be able to request support from your local council.
- Councils are being given funding to provide support to those Clinically Extremely Vulnerable people who need it. This can include help with shopping, securing a priority supermarket delivery slot, or signposting you to local support or befriending services.
- If friends and family are not able to collect your prescriptions or medicines for you, then you will also be eligible for free medicines delivery from your community pharmacy.
- If you cannot work, the Government has extended the Coronavirus Job Retention Scheme (furlough) until 2 December, which you may be eligible for if you were on payroll before 30 October 2020. Please speak to your employer if you think you are eligible.
- Additionally, the letter you will receive can act as evidence for your employer to show that you cannot work outside your home until 2 December and that you are eligible for Statutory Sick Pay (SSP) or Employment Support Allowance (ESA), provided other eligibility criteria are also met.
20. How will CEVs be able to access support?
- Request priority access to supermarket delivery slots (if you have already got priority supermarket deliveries, you’ll keep them).
- Tell your council if you need support in order to follow this guidance that cannot be provided by friends, family or other support networks.
- Update your details, for example, your address.
- CEVs can use a new online service to register themselves, or on behalf of someone else, to:
- This service can be found at https://www.gov.uk/coronavirus-shielding-support. You’ll be asked for your NHS number. You can find it on any letter the NHS has sent you, or on a prescription.
- If you need to register your needs by phone, or have an urgent need, you should contact your local council directly.
- Find out what help you is available from your local council at https://www.gov.uk/coronavirus-local-help.
21. What food support is available for me/CEVs?
- You are advised not to go to the shops. Use online shopping if you can, or ask friends, family or local charities to collect and deliver shopping for you.
- If you cannot access food, your local council can offer support. This may include helping you to request priority access to supermarket delivery slots (if you do not already have one) or help with shopping.
- If you need to register for help getting access to food you can go to https://www.gov.uk/coronavirus-shielding-support.
- NHS Volunteer Responders may also be able to help deliver your food shopping. To arrange support for yourself or someone else call 0808 196 3646.
22. How can I/CEVs access priority supermarket slots?
- Seven of the UK’s largest supermarkets (Asda, Sainsburys, Tesco, Morrisons, Iceland, Waitrose, Ocado) are continuing to offer priority supermarket slots to Clinically Extremely Vulnerable people who need them.
- If you are already receiving priority access to supermarket delivery slots this will continue, you do not need to do anything further.
- You can use a new online service to register yourself, or on behalf of another CEV individual, to request priority access to a supermarket delivery slot at https://www.gov.uk/coronavirus-shielding-support.
23. Why am I/CEVs no longer receiving a food box?
- Government will not be re-introducing nationally provided food parcels. We have moved to the locally led support model which recognises that councils are best placed to assess and meet CEVs food access needs with a focus on providing support in a way that encourages independence and choice.
- Use online shopping if you can, or ask friends, family or local charities to collect and deliver shopping for you.
- If you cannot access food, your local council can offer support. Local councils are now being funded to provide support to those Clinically Extremely Vulnerable people who need help to access food. This may include helping you to request priority access to a supermarket delivery slot (if you do not already have one) or help with shopping.
24. What other support is available for people who are staying at home?
- Local councils are being given funding to provide support to those Clinically Extremely Vulnerable people who need it. This may include signposting you to local support or befriending services, or linking you up with volunteers who can help collect essential deliveries for you.
- If you need to register your needs by phone, or have an urgent need, you should contact your local council directly. Find out what help you might be able to get from your local council at https://www.gov.uk/coronavirus-local-help.
- NHS Volunteer Responders may also be able to help with their ‘check in and chat service’. To arrange support for yourself or someone else call 0808 196 3646.
25. Can I/CEVs go to work?
- If you are Clinically Extremely Vulnerable, you should not work outside the home until 2 December. Your employer is expected to help you to work from home.
- CEV employees or workers should talk to their employer as soon as they can about the new guidance.
- If you are unable to work in your normal role or do all of your usual tasks from home, you should discuss whether there are any alternative arrangements that can be made with your employer, including considering using the Coronavirus Job Retention Scheme )CJRS), or furlough scheme. The Government has now extended this until 31 March 2021, and the guidance states that individuals who are CEV should be eligible. You can read the full guidelines here.
- Employers across all sectors should therefore continue to facilitate working from home for staff who are CEV, wherever possible. If this is not feasible, furlough should be considered as an alternative. This applies even if the business or organisation stays open or continues to function normally.
- If you feel that you may be eligible under the scheme, talk to your employer in the first instance. If you have received a shielding letter you can show this as evidence that you are considered to be CEV.
Is it safe for people who live with CEVs to go to work?
- Everyone is being advised to work from home where they can.
- Where it is not possible to work from home, household members who themselves are not classified as Clinically Extremely Vulnerable can still go to work if they cannot work from home.
- Household members who live with CEVs should take extra care to follow the public health guidance on hand washing, social distancing, and complying with any Covid secure workplace guidance.
- You should try to remain two metres apart from each other, especially if household members display symptoms of the virus or have been advised to self-isolate.
- If you have caring responsibilities as a result of the coronavirus pandemic, you may also be eligible under the CJRS. This includes if you have to stay at home to care for a child who cannot attend school because they are CEV. Again, the first step is to speak to your employer about any policies that may already be in place. Employees have the right to take time off for dependants, although this is unpaid. You can also request flexible working arrangements if you have been employed for at least 26 weeks; and this should be accepted by the employer unless there are sound business reasons for not doing so.
26. What support is available?
- The Government has extended the Coronavirus Job Retention Scheme (furlough) until 2 December which you may be eligible for if you were on payroll before 30 October 2020. Please speak to your employer if you think you are eligible.
- If you cannot work, you may be eligible for Statutory Sick Pay (SSP), Universal Credit (UC) or Employment Support Allowance (ESA). Eligibility criteria apply.
- The letter you will receive will act as evidence for your employer or the Department of Work and Pensions that you are advised to shield and may be eligible for SSP or ESA.
- SSP is payable for up to 28 weeks per sickness absence. If an individual has used up their SSP entitlement, they may be able to claim UC and/or ESA when their SSP ends, depending on individual circumstances.
- SSP is intended as a safety net for individuals who are clinically extremely vulnerable, in cases where their employer chooses not to furlough them under the Coronavirus Job Retention Scheme and does not have other suitable policies in place (e.g. the ability to work from home, or the provision of special leave).
27. What support is available for self-employed CEVs who cannot work from home?
- The Government recognises the continued impact that coronavirus (COVID-19) has had on the self-employed and has extended the Self-Employment Income Support Scheme (SEISS).
- The SEISS Grant Extension provides critical support to the self-employed in the form of two grants, each available for three month periods covering November 2020 to January 2021 and February 2021 to April 2021.
- Further information is available here: https://www.gov.uk/government/publications/self-employment-income-support-scheme-grant-extension/self-employment-income-support-scheme-grant-extension
28. How can CEVs access medicines if they cannot go to the pharmacy?
- If friends and family are not able to collect medicines for you, then you will also be eligible for free medicines delivery.
- Please contact your pharmacy to inform them that you are clinically extremely vulnerable and need your medicines delivered, and they will arrange this free of charge.
29. What mental health support is available for CEVs during this difficult period?
- Anyone concerned about their mental health should speak to their GP or existing care team, or can access further advice via NHS.UK. Online self-referral options are commonly available for some services including children and young people’s mental health services, and psychological therapies services for adults with common mental health problems such as anxiety and depression.
- Every Mind Matters website is available for everyone with advice and practical steps that you can take to support your wellbeing and manage your mental health during this pandemic.
- You may also find helpful resources, including information on how to access counselling and psychotherapy, on the British Association for Counselling and Psychotherapy’s website.
- All mental health providers, including providers of psychological therapies services, have been issued with guidance to encourage them to deliver care remotely so that vulnerable groups, including those who are shielding, can receive care safely.
- 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 now available from The NHS.
- If you or someone you care for are experiencing a mental health crisis, we urge you to make contact with a local health professional immediately.
30. What help is available to pay my mortgage during this lockdown?
- The mortgage holiday will be extended. Borrowers who 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.
- For borrowers who have taken six months’ holiday and continue to face ongoing financial difficulties, lenders should continue to provide support through tailored forbearance options. This could include granting new mortgage payment holidays. Home owners in this situation should speak to their lender to discuss their options.
31. Can I be evicted from my home during this lockdown period?
- Measures to protect tenants during the COVID-19 outbreak remain in place.
- Landlords must provide a six-month notice period for evictions for all but the most egregious cases. Furthermore, no bailiff enforcement will occur during the national lockdown, in line with the existing position for Tier 2 and 3 Local COVID Alert Levels.
32. Can I leave my home if myself or my children are at risk of domestic abuse?
- You do not have to stay in your home if you need to leave to escape domestic abuse.
- Any individual in danger and who is unable to talk on the phone, should call 999 and then either press 55 on a mobile when prompted or wait on a landline and you will be connected to a police call handler who will be able to assist you without you having to speak.
33. Should my CEV child go to school?
- More evidence has emerged that shows there is a very low risk of children becoming very unwell from COVID-19, even for children with existing health conditions. Most children originally identified as clinically extremely vulnerable no longer need to follow this advice. Speak to your GP or specialist clinician if you have not already done so, to understand whether your child should still be classed as clinically extremely vulnerable.
- Those children whose doctors have confirmed they are still clinically extremely vulnerable are advised not to attend school whilst this advice is in place.
34. What provisions will be made available to support children who need to access remote learning and cannot attend school?
- If following a discussion with your GP or clinician you child is unable to attend school, your school will make appropriate arrangements for them to be able to continue their education at home.
35. I am CEV, should my child go to school?
- Children who live with someone who is clinically extremely vulnerable, but who are not clinically extremely vulnerable themselves, should still attend school.
36. Should staff who are CEV continue to work in education and childcare settings?
- No. Government advice is that all CEV individuals should work at home where possible, regardless of which sector they work in. If you cannot work from home then you should not attend work.
- If you cannot attend work for this reason, you may be eligible for Statutory Sick Pay (SSP) or Employment Support Allowance (ESA). The letter you will receive will act as evidence for your employer or the Department of Work and Pensions that you are advised to shield and may be eligible for SSP or ESA.
- If you were on payroll before 30 October 2020 you may also be eligible for the Coronavirus Job Retention Scheme (furlough), which is being extended until 2 December. Please speak to you employer if you think you are eligible.
37. Should staff in education and childcare settings who live with someone who is CEV, stay at home?
- Those who work in the education or childcare sectors who live with someone who is CEV can still attend work if they cannot work from home, in line with the wider rules set out in the new National Restrictions from 5 November.
38. Am I/CEVs safe to send my child to nursery?
- More evidence has emerged that shows there is a very low risk of children becoming very unwell from COVID-19, even for children with existing health conditions. Most children originally identified as clinically extremely vulnerable no longer need to follow this advice. Speak to your GP or specialist clinician if you have not already done so, to understand whether your child should still be classed as clinically extremely vulnerable. Those children whose doctors have confirmed they are still CEV are advised not to attend early years settings whilst this advice is in place.
- Attendance at early years settings will continue to be voluntary and non-statutory, though we encourage parents to continue to send their children unless they are advised that their child remains CEV.
The Government is committed to supporting local councils and voluntary sector organisations to respond to those who have specific support needs and requirements during the COVID-19 pandemic. Details of the support and advice available can be found here.
The updated shielding guidance should not affect any social care or support you were receiving prior to the start of shielding.
Individuals should continue to contact their local council if they have any ongoing social care needs.
Should I get the seasonal flu vaccine?
The seasonal flu vaccine won't protect against COVID-19, but it helps to stop flu that's especially common in the autumn and winter. With autumn now firmly upon us, we are also facing the onset of the winter flu season. If you have systemic sclerosis and/or certain other conditions you may be at a higher risk of developing a more serious illness if you catch flu. You may even have received a letter from the NHS informing you that you are eligible for a free annual flu jab. In England this year, if you're on the shielding list, your whole household will be offered the vaccine, as well as yourself.
Shielding guidance for UK nations - changes since August
Nationwide shielding in Wales has been paused since 16 August.
A letter was sent to everyone in Wales who is shielding to tell them this and what to do next. Unless there are local restrictions, Government guidance says you can now follow the same guidance as the rest of Wales. To stay safe, you should strictly follow physical distancing and hygiene measures. The newly-updated changes to shielding can be found on the Welsh Government website, here.
If you still need support with food deliveries, contact your local authority. The National Volunteer Prescription Delivery Scheme will be available until the end of September.
Note, shielding may continue if you live in one of the local areas with restrictions or lockdown. If you're advised to shield again, the support you receive may vary slightly depending on where you live. Find out more about the support services for people who are shielding.
Nationwide shielding in Scotland has been paused since 1 August.
The Scottish Government have issued new advice and guidance, stating that unless there are local restrictions, the guidance is the same as for everyone else. You should strictly follow the Scottish Government recommendations for protecting others and keeping safe.
At the moment, these shielding changes are not recommended for people living in residential nursing or care homes.
The Scottish Government have produced practical resources and guidance on how to keep safe. See below:
The food box scheme ended on 31 July. However, the wider network of support that was available to those shielding will remain. The Shielding SMS service and the national helpline also remain open. Please use the following link for more information on support if you've been on a shielding list.
Note, shielding may continue if you live in one of the local areas with restrictions or lockdown. If you're advised to shield again, the support you receive may vary slightly depending on where you live. Read the shielding information on the Gov Scot website.
Nationwide shielding in Northern Ireland has been paused since 31 July.
Pausing, rather than stopping shielding is just a precaution and there are no plans for it to restart at the moment. The pause is indefinite, but it remains possible that the guidance will change if the risk increases in the future.
Read more about what these changes mean for extremely vulnerable people.
Social distancing should continue to be followed. People who are vulnerable should continue to take precautions. It is still best to stay at home as much as possible.
Note, shielding may continue if you live in one of the local areas with restrictions or lockdown. If you're advised to shield again, the support you receive may vary slightly depending on where you live. Read the latest guidance on the easing of lockdown and what the changes will mean for you.
Has Scleroderma & Raynaud's UK's guidance changed?
There appears to be some controversy around the changes in guidance for people who are shielding. Some scientific experts and clinicians appear to think it is too soon. SRUK will be seeking further guidance before we update our information, found here.
Ultimately, the decision for someone who is shielding to leave their home is a very personal one. We will do our best to provide reliable information to assist people in making an informed choice.
We appreciate your patience whilst we consult with experts before updating our guidance.