'Clinically extremely vulnerable' patients

Patients who are extremely vulnerable to the coronavirus have now been contacted by the NHS and advised to ‘shield’ themselves by remaining entirely at home for 12 weeks.

However, some patients have contacted us to say they have not received a letter, though they believe they should have done. The NHS has now contacted all the patients it is planning to for this reason. Some of those patients have been wrongly told that their GP cannot add them to the list of highly vulnerable patients.

If you believe you should be included in the highly vulnerable group, your GP can add you and discuss your care options with you. NHS England has written to GPs to tell them this. If your GP tells you that in their clinical judgement you are not in the highest risk group, you can still follow the 'shielding' advice voluntarily if you wish to do so.

If you have received a letter, you can register on the Government's website to receive support and information.

If you have concerns or want to discuss your options, contact your GP or hospital doctor.

The clinically extremely vulnerable group includes patients with the following conditions or undergoing the following treatments:

  • Solid organ transplant recipients
  • People with specific cancers:
    • people with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer
    • 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 which 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
  • People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD
  • People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell)
  • People on immunosuppression therapies sufficient to significantly increase risk of infection
  • Women who are pregnant with significant heart disease, congenital or acquired.

If you are in this group, the advice to shield yourself is advice, not a legal requirement. Full official guidance is available on the Government's website.

'Vulnerable' patients

Some people are considered 'vulnerable' but not in the 'highest risk' or 'clinically extremely vulnerable' group outlined above. If this includes you, you do not have to 'shield' yourself, but you are advised to follow social distancing rules carefully.

This group includes people with the following characteristics or illnesses:

  • aged 70 or older (regardless of medical conditions)
  • under 70 with an underlying health condition listed below (i.e. for adults this usually anyone instructed to get a flu jab as an adult each year on medical grounds):
    • chronic (long-term) respiratory diseases, such as asthma, chronic obstructive
    • pulmonary disease (COPD), emphysema or bronchitis
    • chronic heart disease, such as heart failure
    • chronic kidney disease
    • chronic liver disease, such as hepatitis
    • chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy
    • diabetes
    • problems with your spleen – for example, sickle cell disease or if you have had your spleen removed
    • a weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets or  chemotherapy
    • being seriously overweight (a BMI of 40 or above)
    • those who are pregnant.

Updated: April 17th 2020.