Q and A on new shielding guidance
What guidance should I be following from 6 July?
Those who have received a shielding patient letter remain in the ‘clinically extremely vulnerable’ category and should continue to follow the updated guidance for the clinically extremely vulnerable, bit.ly/3f5aPfG. If the rate of infection does not rise this guidance will be updated on 1 August.
- 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. Register at: www.gov.uk/coronavirus-extremely-vulnerable
- 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
Why have you changed the advice for those classed as clinically extremely vulnerable? What is the evidence base for this decision?
Each step towards relaxing the shielding guidance should be taken carefully. People in this group are still at risk of severe illness if they catch coronavirus and should continue to take precautions, but as the risk of catching coronavirus is now sufficiently low, the Government believes that the time is now right to further relax the advice.
The latest epidemiological data from the ONS COVID-19 Infection Survey shows that the chance of encountering coronavirus in the community has continued to decline. Four weeks ago, on average only one person in 500 had the virus. Last week it was even lower at less than one in 1700. In addition, a test and trace system is now in place, including within schools, and there are robust measures in place to manage potential areas of higher risk.
Will these changes be reassessed before 1 August?
The latest scientific evidence shows that the chance of encountering coronavirus in the community has continued to decline. If this trend continues as expected, the risk levels to those shielding will be low enough for the guidance to be further relaxed from 1 August.
The government regularly monitors this position and if the rates of infection in the community rise, then it may be necessary to advise that more restrictive measures should be taken for people at highest risk from COVID-19 to keep themselves safe.
I’m worried about catching coronavirus – am I still at significant risk?
Clinically extremely vulnerable people are still at risk of severe illness if they catch coronavirus, and should continue to take precautions, even as the levels of coronavirus in the community continue to decline according to the latest epidemiological data from the ONS COVID-19 Infection Survey.
People should continue to socially distance as much as possible and always robustly practice good, frequent hand washing.
Are you planning on telling us to ‘shield’ again in the future?
The latest scientific evidence shows that the chance of encountering coronavirus in the community has continued to decline. The government regularly monitors this position and if the rates of infection in the community rise, then it may be necessary to advise that more restrictive measures should be taken.
The guidance for the clinically extremely vulnerable is advisory.
How will people know that they should start shielding again?
Those who have received a shielding patient letter remain in the clinically extremely vulnerable category and should continue to follow the guidance on ‘shielding and protecting people who are Clinically Extremely Vulnerable’. This guidance will continue to be updated to reflect the most recent advice from the government.
If there is a significant change to the advice, the Government will write to all patients who are clinically extremely vulnerable setting out any changes to advice before they are made.
Is it possible that some regions may have to return to shielding in the future?
The NHS currently manages a national Shielded Patient List in England. The variation in R across the country has been quite limited to date, so a national approach continues to be appropriate. The government regularly monitors this position and will continue to be led by the scientific evidence.
Why is the advice for England different to the advice for other parts of the UK?
As far as possible the conditions that means someone is advised to shield have been consistent between the four UK nations. Each country has slightly different health systems and ways of recording health data, so small differences may arise in implementation.
Each administration has been working to a slightly different timeline on updating their shielding guidance based on when measures were first introduced.
Chief Medical Officers will be monitoring any changes in cases or R rates in each nation and could change their advice depending on how the risk levels change in each nation.
Is my name being kept on a shielding list? Why?
The NHS will continue to maintain the Shielded Patient List allowing us to maintain targeted advice and support to those who are most vulnerable and to change advice and support if incidence was to rise significantly.
Does my whole household have to shield with me until 1 August?
In line with the current public health advice, those living with clinically extremely vulnerable people are not advised to shield themselves. They should support those shielding and carefully follow the guidance on staying alert and safe (social distancing).
Can I see my family and friends?
From 6 July, guidance for extremely clinically vulnerable people will change to advise that those shielding may wish to spend time outdoors in a group of up to 6 people, including people they do not live with, if they choose to do so. If you do go out, you should take extra care to minimise contact with others by maintaining social distancing. This can be in a public outdoor space, or in a private garden, uncovered yard or terrace.
Additionally, those who are shielding will be able to create a ‘support bubble’ with one other household, as long as one of the households in the ‘bubble’ is a single adult household (either an adult living alone or with dependent children under 18). All those in a ‘support bubble’ can spend time together inside each other’s homes, including overnight, without needing to maintain social distancing.
Can I exercise outside? If so, how often and for how long?
Yes, from 1 June the shielding guidance was updated to advise that those classed as clinically extremely vulnerable may wish to spend time outdoors, including for exercise.
From 6 July, this can be in a group of up to 6 people (including people they don’t live with).
There is no advised limit to how often and how long to spend outside, that is up to you, but you should follow social distancing guidelines and always robustly practise good, frequent hand washing.
Can I drive to exercise?
From 6 July the advice for those classed as clinically extremely vulnerable remains that you no longer need to maintain social distancing with people in your household or support bubble (where applicable). Therefore, you can drive to an outdoor location alone or with members of your household or support bubble.
Can I let people into my house now?
If you are not in a ‘support bubble’ with another household, you must not meet other people indoors, including in their home or your home, except for specific circumstances set out here.
Any essential carers or visitors who support you with your everyday needs can continue to visit unless they have any of the symptoms of COVID-19 (a new continuous cough, a high temperature, or a loss of, or change in, their normal sense of taste or smell). Essential carers coming to your home should follow advice on good hygiene: wash their hands with soap and water for at least 20 seconds on arrival to your house and often while they are there (or use hand sanitiser), avoid touching their face, catch any coughs or sneezes in a tissue (or their sleeve), and put used tissues immediately in the bin and wash their hands afterwards. They should maintain social distancing where close or personal contact is not required and where this is possible.
From 6 July, who can I ‘bubble’ with?
From 6 July, those who are shielding will be able to create a ‘support bubble’ with one other household, as long as one of the households in the bubble is a single adult household (either an adult living alone or with depending children under 18). Support bubbles must be exclusive – you should only form a bubble with one household and they should only be in a bubble with you.
What can you do in a ‘support bubble’?
Forming a support bubble with another household means you can meet – indoors or out – without needing to maintain social distancing. You can also stay overnight as if you lived with that household. This means you can have closer contact with those in your support bubble, which should help provide additional support to those who need it. You should continue to adhere to social distancing guidelines in full with other households.
The risk of infection rises with the number of people in a bubble and the number of interactions you have with people you do not live with, so it’s important to take measures to try and protect against this. This means that support bubbles must be exclusive – you should only form a bubble with one household, and they should only be in a bubble with you.
You must not gather indoors or stay overnight with anyone outside of this bubble and should not change your bubble. If you are in a single adult household, you may also want to consider the size of the household you choose to make a bubble with, and where possible, choose a small household. Everyone in a support bubble should isolate when one member of the bubble becomes symptomatic or tests positive for coronavirus.
Can I ‘bubble’ with another shielding household?
Yes, all single adult households can bubble with one other household, including households containing other people who are shielding. Similarly, shielding people living in a household can bubble with any single adult household.
Is bubbling safe?
There are key principles for how you can form a support bubble safely. These are critical to keeping you – and your friends and family – safe and saving lives:
- support bubbles must be exclusive – you should not change who is in your bubble or have close contact with anyone else you do not live with. This is critical to keeping you, and your family and friends, safe
- if you or someone in your support bubble is showing coronavirus symptoms, or otherwise self-isolating, everyone in your support bubble should stay home.
- If you or a member of your support bubble is contacted as part of the test and trace programme, the individual contacted should stay at home. If the individual becomes symptomatic, everyone in the support bubble should then isolate.
Does this mean I can go shopping/to the pharmacy?
The current advice to those who are clinically extremely vulnerable is to not spend time in any other buildings or covered areas apart from your own home (apart from if you are in a ‘support bubble’ from 6 July).
This will change from 1 August, when guidance for this group will be brought in line with that for the clinically vulnerable group. In practice, that means that you should stay home as much as possible, but you can go outside, including to the shops, providing you take particular care to maintain social distancing.
Anybody who is shielding, or self-isolating can seek support from the NHS Volunteer Responders for help with shopping or medication. Simply call NHS Volunteer Responders on 0808 196 3646 (8am to 8pm) to arrange this.
NHS – Access to Services / Treatment
Can I visit my GP surgery or hospital clinic for treatment?
You should contact your GP/hospital clinician in the first instance if you have any concerns/queries about your ongoing care and treatment but please carry on with whatever care/treatment arrangements are currently in place until your GP/hospital specialist tells you anything different. You can contact your GP using econsult at: bit.ly/3e5Ut5c or telephone your own practice.
How can I safely access NHS services outside of my home?
The NHS has already significantly changed the way it operates in order to safely treat and care for those who are at highest risk of severe illness were they to contract COVID-19.
If your GP/hospital specialist asks you to attend an appointment at the GP surgery/clinical/hospital, you can contact them to ask them about the specific infection control arrangements in place locally and to discuss any concerns you might have. Face coverings must be worn at all healthcare settings, unless you are exempt due to disability or medical reasons.
NHS England wrote to your GP or hospital clinician, asking them to review ongoing care arrangements for all patients who were shielding. As a result of this review, many of you will have received regular care or treatment at home, or had hospital appointments cancelled or postponed, if clinically appropriate to do so. These care arrangements may change when the shielding advice is further relaxed from 1 August.
Wherever care at home is not possible, the NHS has been asked to provide safe care in infection-controlled settings, in line with latest infection prevention and control guidance.
Warrington and Halton Hospitals Covid-19 information can be found at: bit.ly/324Tujp
Whiston and St. Helens Covid-19 information can be found at: bit.ly/3e7cnEr
NHS Volunteers can help with transport to a medical appointment, please ask your healthcare professional to organise this.
Can carers visit to provide medical support?
Yes, any essential carers or visitors who support you with your everyday needs can continue to visit unless they have any of the symptoms of coronavirus.
Essential carers coming to your home should follow advice on good hygiene: wash their hands with soap and water for at least 20 seconds on arrival to your house and often while they are there (or use hand sanitiser), avoid touching their face, catch any coughs or sneezes in a tissue (or their sleeve), and put used tissues immediately in the bin and wash their hands afterwards. They should observe social distancing guidelines where close or personal contact is not required and where this is possible.
Are carers and/or NHS staff who are looking after me at home being tested for Covid-19 before they visit?
All domiciliary care staff, volunteers and unpaid carers are able to access testing if they have COVID-19 symptoms.
Will my GP/clinician have been informed about this change/given any guidance?
Yes, the Government has written to the NHS with further information about the changes.
The Government will continue to engage extensively with partners and the healthcare system throughout this process to help ensure they are meeting the needs of those who are clinically extremely vulnerable.
Will my medicines continue to be delivered?
Those supported by the Medicines Delivery Service who continue to need help will receive this support until the end of July.
After this date, if it is not possible for someone to maintain social distancing whilst attending 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).
Will NHS Volunteer Responders continue to support me?
Yes, NHS Volunteer Responders will continue to offer support to those who need it.
In addition, from 16 June, the NHS Volunteer Responders Scheme has been expanded to offer a new ‘Check in and Chat Plus’ role. This new role has been designed to provide peer support and companionship to people who are shielding as they transition to the new guidance.
If you are vulnerable or at risk and need help with shopping, medication or other essential supplies, please call 0808 196 3646 (8am to 8pm), bit.ly/2Z65AXq
Food and support with other essentials
How does this announcement affect the support that I can access?
For some people shielding, adapting to a more normal way of life will take some time, which is why the shielding advice will be relaxed in two stages: first from 6 July, and then again from 1 August. From 1 August people will no longer be advised to shield and the Government’s core support offer will end.
The core offer, which will continue to be available to the end of July, covers the following three areas of assistance:
- Essential supplies – a free, standardised weekly parcel of food and household essentials;
- Medicines – arrangements to have medicines delivered to people’s homes by local community pharmacies or their dispensing doctor;
- Social contact and basic needs – for example, emotional or social support such as people to talk to on the phone or via a computer.
When is my last chance to register for support to help me over the next few weeks?
Final registrations for food support will close on the 17 July, to allow for support to reach individuals ahead of the scheme end date of 31 July.
When will my food delivery stop?
Those in receipt of centrally provided food boxes, who continue to need help, will receive this support while they are advised to shield, until the end of July.
Final registrations for food support will close on the 17 July, to allow for support to reach individuals ahead of this end date of 31 July.
Can I still get access to priority delivery slots?
Priority supermarket delivery slots will continue beyond July for those clinically extremely vulnerable who have already signed up for support.
Final registrations for food support will close on the 17 July.
Where can individuals go for help once the shielding support offer finishes?
There are alternative food delivery options available.
Priority supermarket delivery slots will continue beyond July for those clinically extremely vulnerable who have already signed up for support.
Supermarkets and other retailers also offer telephone ordering and food boxes to make it easier for vulnerable people to shop for themselves.
The NHS Volunteer Responders Programme will continue providing support with food, prescriptions and essential items to those who are self-isolating for any reason. This also includes anyone that is clinically extremely vulnerable, or anyone that is vulnerable for another reason.
If you or a family member meet the criteria, you can call 0808 196 3646 and ask for help. More information is available here: bit.ly/2Z65AXq You can contact Halton Borough Council for support on: 0151 907 8363
Will the Shielded Patients List still be maintained after the end of July?
The NHS will continue to maintain the Shielded Patient List allowing them to maintain targeted advice and support to those who are clinically extremely vulnerable and to change advice and support if incidence was to rise significantly.
Income and Employment Support
Can I go back to work?
Before 1 August: If you have been able to work at home, you should continue to do so. At this time, the Government does not advise CEV individuals to attend their place of work (workplace/’onsite’) if this requires them to leave their home. This guidance remains advisory.
After 1 August: From 1 August the Government will further relax advice to those shielding, bringing it in line with the advice to those who are clinically vulnerable. In broad terms, this means that although the advice is still to stay at home as much as possible, those shielding may wish to go out to more places and see more people, as long as they take particular care to minimise contact with others outside their household and follow hygiene measures. This means that if they are unable to work from home but can work on site, they should do so, provided the business is COVID-safe.
What about workers who live with someone who is clinically extremely vulnerable and previously advised to shield. Can they go back to work now?
People living with those who are clinically extremely vulnerable should continue to take extra care to follow the social distancing rules, including at work to the extent possible. The Government position is that they should also work from home if they possibly can.
What if I can’t work from home and my workplace can’t offer social distancing?
All employers have been asked to work with the government 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. Employers and employees should start having these conversations as early as possible before the guidance is changed on 1 August.
Where this 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. If employers cannot provide a safe working environment, they will still be able to access a range of government support: this includes the Coronavirus Job Retention Scheme for employees who have previously been furloughed for a full three-week period prior to 30 June and the Self-Employed Income Support Scheme.
I don’t feel safe enough to go back to work, could I face disciplinary action? What are my rights?
You should look to come to an agreement with your employer and understand their specific policies around health and safety and workplace attendance, especially in relation to COVID-19.
If you have concerns about your health and safety at work, you can raise them with any union safety representatives, or ultimately with the organisation responsibility for enforcement in your workplace, either the Health and Safety Executive or your local authority.
You can get advice on your specific situation and employment rights by visiting the Acas website or calling the Acas helpline, 0300 123 1100. Locally Citizens Advice Halton can offer advice and information around work and benefits. Contact them at: 0344 477 2121 email: email@example.com
What if I am told to shield again in the future, will I lose my job? Will the Government support me to protect my job/income?
Where possible, your employer should help you to work from home.
If home working is not possible, employers will be able to access the Coronavirus Job Retention Scheme for clinically extremely vulnerable employees who have previously been furloughed for a full three-week period prior to 30 June.
For those who have not been furloughed, clinically extremely vulnerable employees who are notified (by the NHS, their GP or Government letter) to shield again will again be entitled to Statutory Sick Pay for the period they are advised to shield themselves, if all other SSP eligibility rules are met.
The existing employment rights framework provides protections against discrimination, unfair dismissal and detriment. These protections ensure fair treatment of those who public health guidance recommends to take additional steps to reduce the risk of becoming ill with COVID-19.
You can get advice on your specific situation and your employment rights by visiting the Acas website https://www.acas.org.uk/contact or calling the Acas helpline, 0300 123 1100. Locally Citizens Advice Halton can offer advice and information around work and benefits. Contact them at: 0344 477 2121 email: firstname.lastname@example.org
Guidance around shielding will be continually reviewed and informed by the latest scientific evidence and advice. Support measures will remain under review by the government and will consider what changes may need to be made as the advice to the clinically extremely vulnerable evolves.
Can I still get statutory sick pay following the initial relaxation of shielding guidance (between 6 and 31 July)?
You will be eligible for Statutory Sick Pay (SSP) on the basis of your shielding status until 31 July. SSP eligibility criteria apply.
Will I still be able to get Statutory Sick Pay from 1 August, with the shielding guidance for being brought in line with that for the Clinically Vulnerable?
From 1 August, the government will no longer advise people to shield because they are clinically extremely vulnerable. This means that from 1 August individuals who are currently shielding will be able to return to work. Therefore, you will no longer be eligible for SSP on the basis of being clinically extremely vulnerable.
Employers to help their employees to transition back to work safely and support them to follow strict social distancing in the workplace where they cannot work from home.
Employees will remain eligible for SSP if they are required to self-isolate because they, or someone in their household, has symptoms of COVID-19, and are unable to work as a result. SSP is available to those who are self-isolating because they have been notified by the NHS or public health authorities that they have come into contact with someone who has coronavirus, and are unable to work as a result. SSP also remains available to those who are off sick for reasons other than coronavirus.
SSP eligibility conditions apply.
People who are not entitled to Statutory Sick Pay may be entitled to Universal Credit, New Style Job Seekers Allowance or New Style Employment and Support Allowance.
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.
Refuges have continued to be open throughout the lockdown period to provide safe accommodation for those fleeing domestic abuse. Halton Domestic Abuse Service can help you, call or text: 0300 11 11 247.
Am I allowed to let someone into my house for repairs and maintenance work now?
Tradespeople can visit people’s homes to carry out any work or maintenance provided it is carried out in accordance with the latest guidance on working safely in people’s homes.
If you choose to allow tradespeople into your home, it is good practice to make prior arrangements to maintain social distancing.
Call Healthwatch Halton on 0300 777 6543 or email email@example.com if you would like information, signposting or to feedback about health and social care services.