Shielding – Updated Guidance for Patients Clinically at High Risk

Although shileding was paused on the 1st April and other restrictions have been lifted on July 19th, those who are clinically vulnerable and may have shielded in the past, may want to think carefully about additional steps which they can take to ensure they minimise the risk of COVID.

All High Risk patients should have been offered and received both COVID vaccinations (jabs): if you have not received both vaccinations we ask you to contact the reception at your earliest convenience.

The vaccinations are important but they are not 100% effective and there is emerging evidence that some immunocompromised and immunosuppressed  patients may not respond well to a COVID infection.  The NHS therefore advises High Risk patients to consider the risks of close contact with others in crowded or enclosed spaces.

You can reduce the risk of catching or spreading COVID-19 by following some simple steps, such as:

• Meet outside if possible – the particles containing the virus that causes COVID-19 are quickly blown away which makes it less likely that they will be breathed in by another person

• Make sure the space is well ventilated if you meet inside; open windows and doors or take other action to let in plenty of fresh air

• Consider whether you and those you are meeting have been vaccinated – you might want to wait until 14 days after everyone’s second dose of a COVID-19 vaccine before being in close contact with others

• Wash your hands regularly and avoid touching your face

• Consider continuing to practice social distancing if that feels right for you and your friends

• Asking friends and family to take a lateral flow test before visiting you

• Ask home visitors to wear face coverings

The current Government guidance, in the link below, outlines what you are advised to do  and any support you can access.  In addition to the advice you can take any further precautions you feel you wish to take to protect yourself.

You can see the current Government guidance by clicking here

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.

Definition of clinically extremely vulnerable groups

People who are defined as clinically extremely vulnerable are at very high risk of severe illness from COVID-19. There are 2 ways you may be identified as clinically extremely vulnerable:

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

If you do not fall into either of these categories and have not been informed that you are on the Shielded patients list, you should follow the current general national / local advice.

If you think there are good clinical reasons why you should be added to the Shielded patients list, discuss your concerns with the Practice or your hospital clinician.  GPs and hospital clinicians have been provided with guidance to support these decisions.

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

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



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