Q: I think I should be considered as highest clinical risk, but I haven’t received a letter. What should I do?

Q: I think I should be considered as highest clinical risk, but I haven’t received a letter.What should I do?*****************************************Most people that are within the highest clinical risk group have already received a letterthrough the post. However, we are aware that central records do not yet capture everybody in this group.

What do we mean by extremely vulnerable?

People falling into this extremely vulnerable group include:

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

Shielding is for your personal protection. It is your choice to decide whether to follow the measures we advise. Individuals who have been given a prognosis of less than 6 months to live, and some others in special circumstances, could decide not to undertake shielding. This will be a deeply personal decision. We advise calling your GP or specialist to discuss this.

The NHS in England is directly contacting people with these conditions to provide further advice.

If you think you fall into one of the categories of extremely vulnerable people listed above and you have not received a letter or been contacted by your GP, you should discuss your concerns with your GP or hospital clinician.

We understand this is an anxious time and people considered extremely vulnerable will understandably have questions and concerns. Plans are being readied to make sure you can rely on a wide range of help and support.

  • The process for identifying additional people is continuing.This list is also being reviewed by GPs and hospital clinicians, but at this very busy time it is not a priority for clinical time.

Please continue to follow the usual “social distancing” guidance in the meantime.

Frequently asked questions about these letters:

Some people are enquiring about these letters because they are concerned about attending work.  The are only for those who are extremely vulnerable and who should not leave the house at all.  If you do feel that you have considerable risk factors and are concerned about attending work, the decision about this risk is one that should be made between yourself and your employer.​  Please discuss your concerns further with your employer or Occupational Health department.

If you need a note for work to confirm that you need to self isolate: