New advice for the clinically extremely vulnerable in England

Please Note: All information correct at time of writing on 4 November 2020. We do our very best to make sure our information is as up to date as possible, but we’d encourage you to check the government website for updates as they happen.

The Department of Health and Social Care and Public Health England have today published their updated guidance to those who’ve been identified as clinically extremely vulnerable (who were required to shield during the previous lockdown).

Although this group is not being required to return to full shielding, there are consequences in terms of work, as the guidance makes it clear:

“You are strongly advised to work from home. If you cannot work from home, you should not attend work for this period of restrictions.

Subject to the usual eligibility criteria, Statutory Sick Pay (SSP) will be payable where they are unable to attend work and can’t work from home.

A formal shielding notification will be issued as evidence for employers.

The guidance states:

“If you were on payroll before 30 October 2020, you may also be eligible for the Coronavirus Job Retention Scheme (on furlough), which is being extended until 2 December. Speak to your employer if you think you are eligible.”

Although many employers will be happy to use furlough for shielding employees, technically this may not be the correct use of the scheme if work is available. Therefore our advice remains that employers should contact HMRC through their online chat function, explain what you want to do and get confirmation that this is acceptable. This can then be referenced in any future HMRC audit.

The guidance also makes it clear that those who live with people who are shielding are still able to attend work if they are unable to work from home (the person shielding is advised to try and maintain social distancing within the home).

The list of people required to shield will not necessarily be the same as last time. In particular, many children who were categorised as clinically extremely vulnerable have now been removed from this group. However, those who fall into the clinically extremely vulnerable group will be either:

    1. Those who have one or more of the medical conditions listed below or
    2. Those whose hospital clinician or GP has added them to the Shielded Patients list because they consider them to be at higher risk of serious illness if they contract the virus (clinicians have been given guidance on this)

Either way, the employee should have received something in writing and it’s essential that employers see this to confirm their status (but bear in mind there may be a delay in letters being issued, particularly if they’re coming from individual clinicians rather than the Department Of Health and Social Care).


The list of conditions which automatically qualify someone for clinically extremely vulnerable status are:

  • solid organ transplant recipients
  • those 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 that 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
  • those with severe respiratory conditions including all cystic fibrosis, severe asthma, and severe chronic obstructive pulmonary disease (COPD)
  • those with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell disease)
  • those on immunosuppression therapies sufficient to significantly increase risk of infection
  • adults with Down’s Syndrome
  • adults on dialysis or with chronic kidney disease (stage 5)
  • women who are pregnant with significant heart disease, congenital or acquired

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