Extremely Vulnerable Groups – Questions and Answers – 2nd April 2020
All those identified as being at a very 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 by no later than the end of this week (by 3rd April). This is known as a ‘shielding letter’. Please do not contact your GP this week.
A list of the groups identified as extremely vulnerable are set out at the bottom of this Q&A.
Where can I find further information?
The full range of guidance on coronavirus can be found on the Welsh Government website: https://gov.wales/coronavirus
About the shielding letter from the Chief Medical Officer for Wales
What do I need to do if I receive a letter?
The shielding letter advises people to stay at home for 12 weeks and 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.
The advice to stay at home for 12 weeks means you will need support from others to get food and medicines.
You should first try to get help from:
If you have no support from family, friends or community organisations, then from 31 March, 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 should be on the letter you received from the Chief Medical Officer.
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 will shortly have extra capacity and a record of who has been identified as extremely vulnerable in your area.
We have published information on our website on support for extremely vulnerable people: https://gov.wales/get-coronavirus-support-extremely-vulnerable-person
Do I have to follow the advice in the shielding letter?
Staying at home for 12 weeks 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 this advice. This will be a deeply personal decision. We recommend calling your GP or specialist to discuss this.
What if I think I’m extremely vulnerable and I don’t receive a shielding letter by the end of this week?
To ensure all high risk patients are contacted, GPs have been provided with a list of those who’ve been sent shielding letters to check against their known patients. They will contact any additional high risk patients not identified to provide the advice outlined by the Chief Medical Officer. Whilst we appreciate that you might be anxious, please give your GP some time to look through the lists they have just received.
If you do not receive a shielding letter and your GP 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 you may then need to follow the social distancing guidance for people with other conditions which can be found on https://gov.wales/coronavirus-social-distancing-guidance
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 (set out at the bottom of this Q&A) – or that you care for someone who does. This means it is very important you or they 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. A list of the groups identified as extremely vulnerable are set out at the bottom of this Q&A.
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 specialist 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. A list of the groups identified as extremely vulnerable are set out at the bottom of this Q&A.
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 about their patients. They may know of specific additional patients in their practice who they think are particularly high risk.
GPs will contact anyone within their practice who has not received a letter but who they think needs to follow the advice and may require extra support with food and collecting medicine.
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 https://gov.wales/coronavirus-social-distancing-guidance to strictly follow the social distancing advice in order to help reduce the risk of catching coronavirus.
A list of the groups identified as extremely vulnerable are set out at the bottom of this Q&A.
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 gearing up to help. Please visit: https://thirdsectorsupport.wales/contact/
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 (for example, Motor Neurone Disease; auto-immune 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. If you feel you should be included amongst those who should stay home for 12 weeks because of your own circumstances, then we advise you to discuss it with your GP or specialist.
My GP says that they have not been contacted with a list of people?
GPs were sent a list of their patients who have been sent shielding letters on 31 March.
Given the difficulties of identifying those most vulnerable, in some cases this is going to require judgements by GPs about their patients. They may know of specific additional patients in their practice who they think are particularly high risk.
GPs will contact anyone within their practice who has not received a shielding letter but who they think needs to follow the advice and may require extra support with food and collecting medicine. Whilst we appreciate that you might be anxious, please give your GP some time to look through the lists they have just received.
A letter has been wrongly addressed to me or a family member
Sometimes mistakes can happen – if you are certain that none of the above groups 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 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 will shortly have extra capacity 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 to your employer. You should not go to your normal place of work – you will need to work at home for the next 12 weeks, 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 visit: https://www.gov.uk/universal-credit.
Delivery of food
Am I eligible for a food box?
Only if you have received a shielding letter from the Chief Medical Officer for Wales advising you to stay at home for 12 weeks; and you have no other means of getting food – no family, friends, neighbours or support groups who can deliver to you.
How do I arrange for a food delivery?
If you 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.
When will I be getting my food box?
Arrangements are in place for deliveries to start from the end of this week but 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.
I am unable to access delivery slots for Online Shopping deliveries because I can’t register as vulnerable
We have no control over online delivery systems as these are a matter for the supermarkets concerned. However there is a huge amount of other help available from different organisations in Wales, including essential food deliveries. First and foremost we are asking people to see if they can get help from family, friends and local community organisations before they contact their local authorities for help.
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 gearing up to help. Please visit: https://thirdsectorsupport.wales/contact/
Key workers in your household
I have been asked to stay home for 12 weeks but a member of my household (partner/son/daughter) is a key worker. Do they have to stay at home as well?
No, they do not have to stay at home as well. However, we would advise that you try to separate yourselves in the home environment as much as possible, for example by having separate rooms, and that family members who have to go out take extra precautions when they come home.
List of those who are extremely vulnerable
- 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 chronic obstructive pulmonary disease (COPD)
- People with severe single organ disease (e.g. Liver, Cardio, Renal, Neurological)
- People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as Severe Combined Immunodeficiency (SCID), homozygous sickle cell disease)
- People on immunosuppression therapies sufficient to significantly increase risk of infection
- Pregnant women with significant heart disease, congenital or acquired
- Children (up to the age of 18) with significant heart disease, congenital or acquired