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Information for people who have been identified as being at a very high risk of severe illness from coronavirus.

First published:
3 April 2020
Last updated:

Introduction

All those identified as being at high risk of severe illness from coronavirus (due to a serious underlying health issue) will receive a letter from the Chief Medical Officer for Wales. This is known as a ‘shielding letter’

The Chief Medical Officer for Wales has advised that shielding should continue until the 16 August 2020. A letter is being sent to everyone in Wales who is shielding to tell them this and what to do next. 

The advice for those shielding to stay at home at all times has changed. If you have been shielding you can now form an extended household with another household. However, physical distancing within an extended household should continue where possible.

Those who are shielding at home can continue to leave home to exercise or meet outside with people from another household. You should strictly follow social distancing (2 metres or 3 steps away from another person) and you should practice good hygiene including frequent hand washing for at least 20 seconds or using a hand sanitiser.

The letter contains a range of further information and advice, including how those who have no-one else who can support them can get medication and other essential items such as food.

Local authorities have been provided with the contact details of those who have been identified as high risk to allow local authorities to offer support.

Major supermarkets have been provided with the contact details of those who have been identified as high risk to allow them to prioritise online shopping slots.

To ensure all high risk patients are contacted, GPs and now hospital doctors are able to add people to the shielding list. They can send any additional high risk patients they identify a letter outlining the advice from the Chief Medical Officer.

There is a much broader group of vulnerable people who have not been written to but who have been previously been advised (through published guidance) to rigorously follow the social distancing advice in order to help reduce the risk of catching coronavirus.

People in Wales are not being asked to register as vulnerable but if you are vulnerable you should ask family, friends and neighbours to support you and use online services.

If this is not possible, then the public sector, business, charities, and the general public are there to help.

If you receive support from health and social care organisations, for example if you have care provided for you through the local authority or health care system, this will continue.

The full range of guidance on coronavirus can be found on the Welsh Government website.

About the shielding letter from the Chief Medical Officer for Wales

What do I need to do if I receive a letter?

You should follow this advice until the 16 August 2020. The Chief Medical Officer will write again to those who are shielding by 16 August 2020 to tell them what to do next.

The advice for those shielding to stay at home at all times has changed. This is because there are fewer people with coronavirus and so the risk of catching coronavirus has reduced. The risk of catching coronavirus when outside is low providing social distancing and good hygiene is strictly followed.

Those who have been shielding at home are now able to form an extended household, leave home to exercise or meet outside with people from another household. They should strictly follow social distancing (2 metres or 3 steps away from another person) and should practice good hygiene including frequent hand washing for at least 20 seconds or using hand sanitiser.

You should follow this advice until at least 16 August 2020. The Chief Medical Officer will soon be writing to those who are shielding advising what to do after 16 August 2020.

You may need support from others to get food and medicines. However, you should first try to get help from:

  • family members 
  • friends or other people in your community
  • carers or community organisations
  • voluntary organisations

If you are unable to request online shopping and have no support from family, friends or community organisations, you will be able to request a weekly food box. Each free box will provide essential food for one person for a week, and will be delivered weekly. If more than one person in your household is shielding and has no support they will also receive food.

You can contact your local authority to request a food box – the contact number for your Local Authority is on the letter you received from the Chief Medical Officer (or your GP or hospital doctor).

If you have no support from family, friends or community organisations to collect your medicine please speak to your regular community pharmacy to discuss how you can get your medicine. Pharmacies have extra capacity to make more deliveries and a record of who has been identified as shielding in your area. 

If you have requested a weekly food box and your circumstances have changed, please consider whether you still need to receive it. For example, you might now have a priority online delivery slot, have formed an extended household or receive support from friends, relatives or volunteers.

If you no longer need to receive the box please call the special number for your local authority to ask to cancel it. You can find the number in the letter you received from the Chief Medical Officer.

Do I have to follow the advice in the shielding letter?

Staying at home, except for going outside for exercise or to meet outside with people from another household, is a big ask but it is for your personal protection. It is your choice to decide whether to follow the measures we advise.

Individuals in special circumstances could decide not follow any of this advice. This will be a deeply personal decision. We recommend calling your GP or hospital doctor to discuss this.

What if I think I’m extremely vulnerable and I don’t receive a shielding letter?

To ensure all high risk patients are contacted, GP practices and hospitals are  provided with lists of those who’ve been sent shielding letters to check against their known patients. They can send any any additional high risk patients not identified a letter providing the advice outlined by the Chief Medical Officer. 

If you do not receive a shielding letter and your GP or hospital doctor does not think you need to stay at home then it is possible that you are not, clinically speaking, in the extreme risk category, and we advise you follow the social distancing guidance for people with other conditions

I have received a shielding letter and I don’t know why because I don’t think I am at extreme risk?

You have received a letter because our NHS systems have identified you as having a serious health issue which makes you at high risk of severe illness from coronavirus. This means it is very important you take extra steps to avoid catching coronavirus.

Sometimes mistakes can happen – if you are certain that none of the groups we have identified as extremely vulnerable apply to you, then a mistake may have occurred.

Read the list of the groups identified as extremely vulnerable

We apologise if this has happened; the process of identifying those considered extremely vulnerable involved NHS data staff pulling information from a number of NHS databases and health records.  This process is as accurate as it can be, but may not be perfect.

We recommend calling your GP or hospital doctor to check.

What information did you use to decide I am extremely vulnerable?

We decided who to include in this group based on NHS professional advice.

Read the list of the groups identified as extremely vulnerable

NHS systems have been searched for people who might fall into this category.  Given the difficulties of identifying those most vulnerable, in some cases this is also going to require judgements by GPs and hospital doctors about their patients.

GPs and hospital doctors can send any additional high risk patients not identified a letter providing the advice outlined by the Chief Medical Officer.

Why have I not been identified as extremely vulnerable when I have a health condition?

There is a much broader group of vulnerable people who have not been written to but have been previously been advised through published guidance to strictly follow the social distancing advice in order to help reduce the risk of catching coronavirus.

Read the list of the groups identified as extremely vulnerable

If you are extremely vulnerable you should ask family, friends and neighbours to support you and use online services. If this is not possible, then the public sector, business, charities, and the general public are there to help. Find out more from Third Sector Support Wales.

If you are not within the shielding group, but are self-isolating and you have no support although you will not be able to request a food parcel, you should contact your local authority straight away to ask for help.

I am unhappy that my condition is not on the list of groups identified as being extremely vulnerable

The list of people to be regarded as extremely vulnerable was drawn up on expert clinical advice. It is being reviewed on a regular basis. If you feel you should be included amongst those who should be shielding until at least 16 August 2020 because of your own circumstances, then we advise you to discuss it with your GP or hospital doctor. 

My GP or hospital doctor says that they have not been contacted with a list of people?

GPs were sent an initial list of their patients who have been sent shielding letters on 31 March and these patient lists have been regularly updated. Hospitals have also been sent the patient lists.

Given the difficulties of identifying those most vulnerable, in some cases this is going to require judgements by GPs or hospital doctors about their patients.

GPs and Hospital Doctors can send any additional high risk patients not identified a letter providing the advice outlined by the Chief Medical Officer.

A letter has been wrongly addressed to me or a family member

Sometimes mistakes can happen – if you are certain that none of the groups identified as extremely vulnerable apply to you or a member of your household – a mistake may have occurred. We apologise if this has happened, but as outlined above, whilst every care has been taken, the process may not have been perfect.  We recommend calling your GP to check.

My letter was sent to somebody else’s address

We apologise if this has happened. Sometimes mistakes can happen with data entry which may have resulted in your letter going to the wrong address.

Health and social care arrangements

What about the health and social care support I currently receive?

If you receive support from health and social care organisations, for example if you have care provided for you through the local authority or health care system, this will continue.

What about planned GP appointments? 

Wherever possible, GP appointments will be provided by phone, email or online. If you need to be seen, your GP practice will contact you to let you know what you should do. 

What about planned hospital appointments?

Your hospital or clinic will contact you if any changes need to be made to your care or treatment. Please phone your hospital or clinic if you have any questions about your appointment. 

Some hospital appointments may need to be cancelled or postponed. This is part of the plans to help the NHS to respond to the coronavirus outbreak. You will still be able to contact your hospital care team if you have an urgent issue.

Delivery of medicines

What about medicine deliveries?

If you’ve received the letter from the Chief Medical Officer (or your GP or hospital doctor) and are following the ‘shielding measures’ then you’ll firstly need to see if family, friends or neighbours can collect your medicine from the pharmacy for you.

If this isn’t possible, please speak to your regular community pharmacy to discuss how you can get your medicine.

Pharmacies have extra capacity to make more deliveries and will also have a record of who has been identified as extremely vulnerable in your area. 

Going to work

What about my work?

If you are employed, please show the shielding letter from the Chief Medical Officer for Wales (or your GP or hospital doctor) to your employer. You should not go to your normal place of work – you will need to work at home until the 16 August 2020, if you can do so. You do not need to get a fit note from your GP.

If you need help from the welfare system you can find out more information on GOV.UK

Delivery of food

Am I able to access a priority delivery slot for online shopping deliveries if I have received a letter notifying me I’m part of the shielded group?

Major supermarkets have the details of all those who have received a shielding letter from the Chief Medical Officer for Wales to enable them to prioritise orders for those who are shielding. Details of any further high risk individuals identified by GPs or hospital doctors will also be passed on to the major supermarkets.

Am I eligible for a food box?

Only if you have received a shielding letter from the Chief Medical Officer for Wales (or your GP or hospital doctor); and you have no other means of getting food – meaning you are unable to do online shopping and you have no family, friends, neighbours or support groups who can deliver to you.

Local authorities have the details of all those who have received a shielding letter from the Chief Medical Officer for Wales to enable them to support those who are shielding. Details of any further high risk individuals identified by GPs or hospital doctors will also be passed on to the local authorities.

Local authorities now have the details of all those who have or are due to receive a shielding letter from the Chief Medical Officer for Wales to enable them to support those who are shielding. Details of any further high risk individuals identified by GPs or hospital doctors will also be passed on to the local authorities.

How do I arrange for a food box delivery?

If you are unable to do online shopping and have no family, friends, neighbours or support groups who can deliver to you, then you can contact your local authority to request a food box – the contact number for your local authority is on the shielding letter you received from the Chief Medical Officer (or your GP or hospital doctor).

When will I get my food box?  

You need to get in touch with your local authority.

Your local authority will authorise orders and the food box will be delivered directly to your home by a food service business. Once your delivery begins, it will be a weekly delivery.

Local authorities also have local arrangements in place to help people who are in immediate need – before the deliveries begin.

What will be in my food box?  What about specialist diets and religious requirements? 

The box will contain essential foods in packages and tins but only limited fresh produce. We are not able to vary boxes to take account of dietary requirements but contents will be labelled. We hope to improve this and offer choice at a later stage if that is possible. Please do make sure you check the ingredients very carefully if you have an allergy or other dietary requirement.

A box will provide food and essentials for one person for one week. If there are two eligible people in the house, there will be two boxes.

How do I cancel my food box?

If you have requested a weekly food box and your circumstances have changed, please consider whether you still need to receive it. For example, you might now have a priority online delivery slot or support from friends, relatives or volunteers. Or you may have decided to become part of an extended household.

If you no longer need to receive the box please call your local authority to ask to cancel it. The contact number for your local authority is on the shielding letter you received from the Chief Medical Officer.

What can I do if I am vulnerable but not in the shielding group and am struggling to get food?

If you are vulnerable but not in the shielding group you should ask family, friends and neighbours to help you get food. If this is not possible, you should get in touch with voluntary groups in your area. Find out more from Third Sector Support Wales.

Do I need to register?

Do I need to register as shielding/vulnerable?

People in Wales are not being asked to register as vulnerable. We realise that this is different to the arrangements in England, but in Wales we have decided to take a different approach.

If you are vulnerable but not in the shielding group you should ask family, friends and neighbours to support you and use online services. If this is not possible, then the public sector, business, charities, and the general public are there to help. Find out more from Third Sector Support Wales.

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