New advice for clinically extremely vulnerable patients issued

Posted on: 13th October 2020

The UK Government has announced new measures to help reduce the spread of coronavirus. What these measures are will depend on what part of the country you live in. Please look at the government website for what is happening in your area.

The Government has today published guidance for clinically extremely vulnerable people (those who previously has been advised to shield).

This cohort of people includes patients with chronic liver disease who are on immunosuppressants, any patient with liver cirrhosis and decompensation, liver transplant recipients and people who are waiting for a liver transplant.

This new guidance is designed to support people to take appropriate protective actions in their everyday lives, while retaining as much normality as possible. It will be linked to the new three-tier system of local lockdown measures for England and will provide advice in addition to these measures.  The government has advised the Trust that they will be writing to people on the shielding patient list to advise them of these changes.

If you do not receive a letter but believe that you should be on the shielding list or you receive a letter and believe that you should not be considered extremely vulnerable please contact your clinician.

Shielding advice (staying at home, not going to work or school and limiting social interactions to own household and support bubble) will not automatically be triggered by an area going into a Local Covid Alert Level but those in exceptionally high-risk areas may still be advised to adopt formal shielding in the future.  Support packages may also be re-introduced.

The advice for the clinical extremely vulnerable, which will be in addition to the basic restrictions set out in the Local Covid Alert Levels framework everyone must follow, includes:

  • For Local Covid Alert Level - MEDIUM: strictly observe social distancing, meet others outside where possible, limit unnecessary journeys on public transport and work from home where possible, but you can still go to work and children should still attend school. This is on top of restrictions for everyone to only meet in groups of up to six people.
  • For Local Covid Alert Level - HIGH: reduce the number of different people you meet outside, avoid travel except for essential journeys, work from home where possible and reduce the number of shopping trips made or go at quieter times of the day. You can still go to work if you cannot work from home because all workplaces should be covid secure, and children should still attend school. This is on top of restrictions for everyone to not meet other households indoors, unless part of a support bubble, and to only meet in groups of up to six people outdoors.
  • For Local Covid Alert Level - VERY HIGH: work from home, in general stay at home as much as possible, and avoid all but essential travel. You should also significantly reduce shopping trips, and if possible use online delivery or ask people in your household, support bubble or volunteers to collect food and medicines. People in these areas are encouraged to still go outside for exercise, and can still go to school and to work if they cannot work from home.

The government has said that they recognise that a small number of individuals may require additional support to follow the guidance at this alert level, and they are advised to contact their local authority if they need assistance.

You can also read more by looking at the framework here: Local COVID Alert Levels - Table Comparison.

Vanessa Hebditch, Director of Policy at the British Liver Trust says: “Our helpline has received an increasing number of calls from patients who are understandably concerned about the rising numbers of Covid cases in the UK. It is a worrying time for everyone but this is magnified if you are clinically vulnerable or extremely clinically vulnerable.  The new guidelines reflect how there are different levels if risk dependent on where you live, and our advice is to check for updates regularly and strictly follow the guidance.  If you are unsure of what to do, please do call your GP, doctor or specialist nurse for tailored advice."

If you are a liver patient, you can read our Covid FAQs which includes how to assess your personal risk.

It is extremely important that clinically extremely vulnerable people continue to receive the care and support they need to help them 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. You should continue to seek support from the NHS for your existing health conditions. If you are told to go to hospital for a routine appointment, then the NHS has measures in place to make sure that it is safe for you to do so.