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This publication is d under the terms of the Open Government Licence v3. To view this licence, visit nationalarchives. Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned. This guidance is for everyone who has been identified as clinically extremely vulnerable.

If you are in this group, you will ly have received a letter from the NHS or from your GP telling you this. You may have been advised to shield in the past.

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This guidance has been updated to support the clinically extremely vulnerable in protecting themselves from exposure to coronavirus COVID It replaces guidance on shielding that was in place during the 4-week period of national restrictions. The guidance is set out in 2 parts:. Updated advice on protecting the clinically extremely vulnerable, based on the tiers of local restrictions in your area.

The advice sets out the additional things people at the highest risk from COVID are advised to do to keep themselves safe for each tier. Updated shielding advice that is more targeted and largd only apply in some of the worst affected areas and only for a limited period of time.

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Currently, clinically extremely vulnerable people in Tier 4 areas are advised to follow shielding advice. No other areas are currently advised to shield.

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Lookjng country has moved back to a tiered system of local restrictions. We have reinstated this guidance for clinically extremely vulnerable people linked to these tiers. A fourth tier of restrictions was introduced on 20 December This guidance offers additional advice to the clinically extremely vulnerable over and above the rules for the tiers, which apply to everyone.

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This guidance aims to strike a better balance between providing practical steps to help keep you safe while reducing some of the potentially harmful impacts on mental and social wellbeing that were associated with strict shielding. It sets out the steps clinically extremely vulnerable people can take to protect themselves for each local tier.

In the future, the government will only reintroduce formal shielding advice in the very worst affected local areas and for a limited period of time. Currently, this only applies to those areas in Tier 4.

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You can check the tier for your local area or search by postcode. If you are required to travel into an area in a different tier for example to go to work or schoolyou should follow the guidance for whichever area is in the higher tier. For example, if you live in a Tier 1: Medium area but work in a Tier 2: High area, follow the work advice for Tier 2: High. If you live in a Tier 2: High area but work in a Tier 1: Medium area, continue to follow the advice for Tier 2: High areas.

These general principles apply at all local tiers. In addition to the rules you and your community must follow at each level, you can take additional precautions to protect yourself.

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Continue to maintain strict social distancing, wash your hands regularly and avoid touching your face. Try to keep the of social interactions that you have low. Avoid gatherings with large s of people, especially indoors, because it ificantly increases the risk of viral transmission. If the rules womxn you to meet with others outside your household, your risk of catching COVID is lower if you meet them outdoors.

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If you meet indoors, keep the area well ventilated with fresh air, for example by opening the window. You can also go out and exercise in an outdoor public place; further information on llooking you can keep fit and healthy is available.

Continue to observe strict social distancing with anyone outside of your household or support bubble. The more you socially distance from others, lokoing your own household, the less likely you are to catch COVID You should always stay at least 2 metres away from other people visiting your home.

Everyone is currently advised to work from home where possible. As a general principle, working from home reduces the chance of you being exposed to the virus. If you need support to work at home or in the workplace you can apply for Access to Work. Access to Work will provide support for the disability-related extra costs lkoking working that are beyond standard reasonable adjustments an employer must provide.

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Clinically extremely vulnerable people should not go to the workplace if they live llooking work in areas where shielding advice is active. Currently this applies to Tier 4 areas only. Otherwise, if you cannot work from home, you can still go to work in Tiers 1, 2 and 3. Your employer is required to take steps to reduce the risk of exposure to COVID in the workplace and should be able to explain to you the measures they have put in place to keep you safe at work.

Where employers are not managing the risk of COVID, the Health and Safety Executive t local authorities will take action which can range from the provision of specific advice, issuing enforcement notices, stopping certain work practices until they are made safe and, where businesses fail to comply with enforcement notices, this could lead to prosecution. If you have concerns about your health and safety at work you can raise them with your workplace union, the Health and Safety Executive or your local authority.

Consider how to get to and from work.

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If you need to use public transport, you must wear a face covering unless you are exempt. Consider travelling outside peak hours to reduce the of people with whom you come into contact. If you have concerns you can get advice on your specific situation and your employment rights by visiting the Acas looking for a large to very woman or calling the Acas helpline on If you cannot make alternative arrangements, your employer may be able to furlough you under the Coronavirus Job Retention Schemewhich has been extended until the end of April You should have a conversation with your employer about whether this is possible.

The UK Chief Medical Officers have issued a statement on schools and childcare reopening which states that there is a very low rate of severe disease in children and young people from COVID Schools have their own measures in place to limit the risk of transmission which can be found in guidance on reopening of schools. Shielding advice is currently in place in Tier 4, so all children still deemed clinically extremely vulnerable are advised not to attend school.

Children and young people whose parents or carers are clinically extremely vulnerable can continue to go to school.

If you need to travel, walk or cycle lookig you can. For longer journeys, or if you are unable to walk or cycle, try to minimise the of people you come into close contact with. Travelling by car is likely to mean fewer social contacts than travelling by public transport.

You should avoid sharing a car, especially with people outside of your immediate household or support bubble. Consider shopping lafge going to the pharmacy at quieter times of the day. You must wear a face covering in all shops unless you are exempt. Volunteers can collect and deliver shopping, medication and other essential supplies.

Call between 8am and 8pm, 7 days a week to self-refer or visit ,arge Volunteer Responders for further information. Whatever tier your local area is in, it is important that you continue to receive the care and support you need to help you stay safe and well. Providers of social care and medical services are making every effort to ensure services remain open and as safe as possible.

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You should continue to seek support from the NHS for your existing health conditions. You can access a range of NHS services from home, including ordering kooking prescriptions or contacting your health professional through an online consultation. If you have an urgent medical need, call NHS or, for a medical emergency, dial Any carers or visitors who support you with your everyday needs can continue to visit.

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They should follow social distancing guidance where close or personal contact is not required. If your carer is a paid carer visiting you in your home, they will find information on foor provision of home care and personal protective equipment PPE in the provision of home care guidance and PPE for care workers delivering homecare guidance. If you receive unpaid care, your carer should refer to the Largf for those who provide unpaid care to friends or family.

You should continue to access support from local charities and organisations, as well as NHS Volunteer Responders. As well as helping with shopping and medicines delivery, NHS Volunteer Responders can help with a regular, friendly phone call, either with someone else who has ly been advised to shield or with different volunteers and transport to medical appointments.

Speak to your health care professional to arrange transport support.

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It is also important to look after your mental health. Go to the Every Mind Matters website for advice and practical steps that you can take to support lookjng wellbeing and manage your mental health during this pandemic.

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. At Tier 1: Mediumwhen seeing friends and family you do not live with or have formed a support bubble with you must not meet in a group of more than 6, indoors or outdoors.

In addition, we advise clinically extremely vulnerable people to take extra precautions by strictly maintaining social distancing, meeting outside if possible, and keeping the of different people they meet low. You are encouraged to exercise in an outdoor public place. The more you socially distance from others, including your own household, the less likely you are to catch COVID but you should in any case always stay at least 2 metres away from other people visiting your home. If you cannot work from home, you can still attend your workplace as your workplace should be COVID-secure.

The general advice on work has further details about what to do if you have concerns. All pupils and students should continue to attend education settings at all local tiers unless they are one of the very small of pupils or students under paediatric or other NHS care and have been advised by their GP or clinician not to attend an education setting. Children and young people whose parents or carers are clinically extremely vulnerable can also continue to go to school.

There are no restrictions on travel at Tier 1: Medium. We advise clinically extremely vulnerable people to limit journeys on public transport where possible. We advise clinically extremely vulnerable people to consider shopping or visiting the pharmacy at quieter times of the day. You can further protect yourself by strictly observing good hand hygiene and maintaining social distancing as much as possible.

At all times, you should continue to access the social care and medical services you need. Providers of these services are making every effort to ensure services remain open and as safe as possible. You should continue to access the NHS services that you need, and you should contact the NHS if you have an urgent or emergency care need. At Tier 2: Highyou must not meet with people indoors in any setting unless they are part of your household or support bubble.