From July, people with underlying health issues will no longer have to avoid all contact with others...

The UK government has announced new plans for the 'extremely clinically vulnerable' - many of whom have not left their homes in three months.

In England, the shielding scheme will begin to wind down next month. From July 6, the two million people affected will be able to leave their homes to meet friends and family outside in groups of up to six and form a ‘support bubble’ with another household, in line with the rules for the wider population. Shielding will then be completely paused from August 1. It means people with serious underlying health conditions including respiratory diseases, some cancers and transplant patients will follow roughly the same rules as the rest of the public.


Why is the advice changing?

The UK government says it has worked with clinicians, GPs, charities, the voluntary sector and patient groups on the changes. The government says the advice can be relaxed because the chances of encountering the virus in the community continue to fall - one in 1,700 people are estimated to have the virus now, down from 1 in 500 four weeks ago. 


What was the guidance before the changes?

As the country went into lockdown, around two million people were sent letters by their GPs telling them not to leave home and to avoid contact with others. This was to protect them from the virus because they were considered to be most at risk from Covid-19. Among the list of people who should be shielding are solid organ transplant recipients, cancer patients undergoing chemotherapy, pregnant women with heart disease and people with severe respiratory conditions such as cystic fibrosis and severe asthma.

Since the start of June, people shielding in England were told they could go out once a day - to meet one person from another household while adhering to social distancing.

From the beginning of August, that shielding advice is to be completely relaxed.

The NHS will keep the shielded list, in case more advice needs to given to this group in future.


Who are the 'extremely clinically vulnerable'? 

Clinically extremely vulnerable people may include:

  • Solid organ transplant recipients.
  • 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

  • People with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell).
  • People on immunosuppression therapies sufficient to significantly increase risk of infection.
  • Women who are pregnant with significant heart disease, congenital or acquired.
  • Other people have also been classed as clinically extremely vulnerable, based on clinical judgement and an assessment of their needs. GPs and hospital clinicians have been provided with guidance to support these decisions.
  • People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD).


Changes to extra support

Support for people who are undergoing chemotherapy for cancer, have a damaged immune system or have had an organ transplant will continue to the end of July.

NHS Volunteer Responders will still be able to help with collecting shopping or medication, a regular friendly phone call, or transport to appointments.

Shielded people will also retain their priority for supermarket delivery slots. But the government's direct food parcel and medicine deliveries will come to a close at the end of July. Also, shielding people will no longer be paid Statutory Sick Pay from August 1, unless they develop symptoms or are told to isolate.

For some, the shielding scheme relaxations will offer a sense of relief and even excitement. But others, who may have felt safer under the scheme, may be feeling even more anxious than the start of the outbreak.

If you are worried, have further questions or would like to talk to someone qualified, you can ask a question to Liz, our resident Oncology Specialist Nurse here.


What about the rest of the UK?

In the UK,  England is the first to completely relax its shielding advice. For those in Scotland, Ireland and Wales, the advice remains the same until further notice.


For the latest information and advice visit:


Public Health England

Macmillan Cancer Support 

Cancer Research


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