News Plans to ease guidance for over 2 million shielding

Millions of people shielding from coronavirus (COVID-19) will be advised they can spend more time outside their homes from Monday 6 July, the Health and Social Care Secretary has announced.

• Advisory guidance to be eased for 2.2 million clinically extremely vulnerable people across England, as virus infection rates continue to fall
• From Monday 6 July, those shielding from coronavirus can gather in groups of up to 6 people outdoors and form a ‘support bubble’ with another household
• Government shielding support package will remain in place until the end of July when people will no longer be advised to shield

Hailing the resilience of those who have been shielding, the Health and Social Care Secretary confirmed from Monday 6 July they will be able to spend time outdoors in a group of up to 6 people including those outside of their household, while maintaining social distancing.

Those who are shielding and live alone or are single parents with children will also be able to create a ‘support bubble’ with one other household of any size, following the same rules already in place for the wider population.

This comes as the latest scientific evidence shows the chances of encountering the virus in the community continue to decline, but the government is committed to continuing with the unprecedented package of support until the end of July to give those shielding time to adjust to these changes.

From Saturday 1 August, the guidance will then be relaxed so clinically extremely vulnerable people will no longer be advised to shield, but support will remain available from NHS volunteers and local councils. People will retain their priority for supermarket delivery slots, and still be able to access help with shopping, medication, phone calls and transport to medical appointments.

While this group of clinically extremely vulnerable people should continue to follow strict social distancing measures, they will be able to participate in more activities such as visiting shops and places of worship.

From 1 August, those who need to work and cannot do so from home will be able to return to work as long as their workplace is COVID secure, adhering to the guidance available.

Deputy Chief Medical Officer, Dr Jenny Harries, said:

Shielding was introduced to safeguard those who, at the start of the epidemic in the UK, were thought to be most clinically vulnerable in our communities. We know how difficult this period has been and the impact shielding has had on many people’s mental health.

The prevalence of the virus in the community is now lower and chances of getting infected are reduced, so we believe it is the right time to relax some of the advice so people can start to regain a degree of normality once more in their daily lives.

People should continue to follow social distancing guidance when outside their homes, as well as frequently washing their hands, to minimise the risk of becoming infected. We will continue to monitor the evidence closely and adjust the advice accordingly if there are any changes in the rates of infection that could impact on this group.

Health and Social Care Secretary Matt Hancock said:

I want to thank all those who have been shielding for so many weeks for their commitment to the shielding programme. I know this has been incredibly tough. Shielding has involved not leaving your house for months, not seeing people you care about, not being able to wander to the park for some fresh air, or even pop to the shops for something you need. This sacrifice has been for a purpose, and I want to thank every single one of you.

We knew it was a difficult ask, but these measures have been vital in saving lives. Now, with infection rates continuing to fall in our communities, our medical experts have advised that we can now ease some of these measures, while keeping people safe.

The government has worked closely with clinicians, GPs, charities, the voluntary sector and patient groups to consult on these changes and will continue to do so to provide support and advice to those they represent.

Following this review of the shielding measures, the government will be writing to all individuals on the Shielded Patient List with updated information on shielding advice and the ongoing support that will be available to them.

Communities Secretary, Robert Jenrick, said:

The resilience and fortitude shown by those that have needed to shield has been inspiring. It’s good news that we are now in a position to start easing some of the restrictions, which I know will be welcomed by many.

I also want to reassure everyone that we will continue to deliver the unprecedented package of support including food and medicine deliveries until the end of July. You will be sent information that will explain what support is available after that, you will not be on your own.

I want to thank councils, health and care professionals, the food industry, key workers and volunteers for their staggering effort to deliver a programme on a scale not seen since the Second World War. Your combined efforts have supported millions of people during this difficult time.

The rates of the virus are now low enough to allow for our advice to be carefully and safely eased, as on average less than 1 in 1,700 in our communities are estimated to have the virus, down from 1 in 500 4 weeks ago.

Those identified as clinically extremely vulnerable should continue to remain at home as much as possible, taking particular care to minimise contact with others outside their household and practise good, frequent handwashing.

We recognise that individuals unable to work from home may feel uncertain about returning to work. Mindful of this, the government is asking employers to ease the transition for their clinically extremely vulnerable employees, ensuring that robust measures are put in place for those currently shielding to return to work when they are able to do so.

For anyone concerned about returning to work once the guidance has eased, we recommend they speak with their employer to understand their specific policies in relation to COVID-19. We advise they discuss their situation, agree a plan for returning to work and adjustments that may be needed before they return.

The NHS will maintain the Shielded Patient List to ensure that we continue to provide the best advice to those identified as clinically extremely vulnerable. Should the level of the disease in the community rise in the future, it may be necessary to advise that more restrictive measures should be taken in order for those at highest risk to keep themselves safe.

Background information

The updated guidance for those classed as clinically extremely vulnerable will be published on 6 July and 1 August as these measures come into force. The dates allow for a gradual return to normality for people who have been shielding strictly and for careful monitoring of the epidemiology of disease during wider easing policies, with 2 to 3 weeks being required to observe clear changes in hospitalisation or intensive care use if population rates were to rise.

There are around 2.2 million people in England with underlying severe health conditions who have been advised to stay at home and avoid non-essential face-to-face contact. These are people of all ages – with specific medical conditions identified by senior UK clinicians – who are at greater risk of severe illness from coronavirus. (See the full list of conditions.)

There are a number of ways that those who are identified as clinically extremely vulnerable can access food and other essentials:

• Make use of the supermarket priority delivery slots that are available for this group. When a clinically extremely vulnerable person registers online as needing support with food, their data is shared with supermarkets. This means if they make an online order with a supermarket (as both a new or existing customer), they will be eligible for a priority slot
• If a person meets the criteria to get support from the NHS Volunteer Responders programme, they can call 0808 196 3646 to be linked with a volunteer who can do a food shop for them. A carer or family member can also do this on their behalf
• If they need urgent help and have no other means of support, they can contact their local council to find out what support services are available in their area
• Use the many commercial options now available for accessing food, including telephone ordering, food box delivery, prepared meal delivery and other non-supermarket food delivery providers. Local authorities and charities are able to provide a list of commercial food access options

Support will continue to be available through the NHS Volunteer Responder Scheme beyond the end of July. NHS Volunteer Responders can support with:

• collecting shopping, medication (if your friends and family cannot collect them for you) or other essential supplies
• a regular, friendly phone call which can be provided by different volunteers each time or by someone who is also shielding and will stay in contact for several weeks
• transport to medical appointments

In addition to the unprecedented economic support package, for anyone facing financial hardship the government has made £63 million available to local councils in England to help those who are struggling to afford food and other essentials.

If someone who is shielding does not need the free government food box anymore, including because they have started to get online supermarket deliveries, they should re-register through the GOV.UK website as no longer needing a food delivery. Alternatively, they can inform their delivery driver at the door that they no longer require these food parcels.

We will ensure that councils continue to be funded for their role in supporting people to shield as long as guidance necessitates this.

To date, support for those shielding includes:

• over 3 million free boxes of essential food have now been delivered by wholesalers to those at highest risk across England, with around 300,000 boxes being distributed every week
• Seven major supermarkets signed up to providing priority delivery slot access to those shielding
• up to 200,000 calls a day have been made to the shielded to confirm their support needs, and councils are helping to support them in other ways – including organising regular calls from volunteers to those isolated
• over 1 million free medicine deliveries provided by community pharmacies in April and May to those who have been advised to shield
• support from over 500,000 NHS volunteers including telephone calls to shielding individuals and others who are at risk of loneliness as a consequence of self-isolation

People in the clinically extremely vulnerable group should continue to access the NHS services they need during this time. This may be delivered in a different way or in a different place than they are used to, for example via an online consultation, but if they do need to go to hospital or attend another health facility for planned care, extra planning and protection will be put in place.

An NHS Medicine Delivery Service is available from community pharmacies and dispensing doctors. It ensures the delivery of medicines to shielded patients where family, friends or volunteers cannot collect them.

From 6 July, in line with the wider guidance for single people in the general population, those shielding may form a ‘support bubble’ with one other household. This means single adults or single parents who are shielding can create a ‘support bubble’ with any household, and households with a shielded person in it can also form a ‘support bubble’ with any single person (or single adult with children).

Anyone not already in contact with mental health services seeking urgent help for their mental health can visit the NHS.UK ‘Where to get urgent help for mental health’ webpage, which lists a range of options that can be accessed, including local 24/7 NHS urgent mental health telephone helplines.

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